Active NPI
Regional Health Providers LLC
- Addiction Medicine (Family Medicine) Physician
- Fairfax, VA
National Provider Identifier
1154898997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- Legal business name
- REGIONAL HEALTH PROVIDERS LLC
- Practice address
- 3917 Old Lee Hwy Ste 11D
Fairfax, VA 22030-2431 - Phone
- (703) 691-4000
- Fax
- (703) 691-4010
- NPI assigned
- Oct 30, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Evelyn Loch
- Title
- Credentialing Billing Manager
- Phone
- (703) 249-9079
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | Primary |
Addresses
Primary practice location
3917 Old Lee Hwy Ste 11D
Fairfax, VA 22030-2431
Mailing address
3917 Old Lee Hwy Ste 11D
Fairfax, VA 22030-2431
Phone (703) 691-4000
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2171677 | Regional Health Providers, LLC | Certificate of waiver | Sep 5, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1540944000000",
"number": "1154898997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3917 OLD LEE HWY STE 11D",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220302431",
"telephone_number": "703-691-4000",
"fax_number": "703-691-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3917 OLD LEE HWY STE 11D",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220302431",
"telephone_number": "703-691-4000",
"fax_number": "703-691-4010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGIONAL HEALTH PROVIDERS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-30",
"last_updated": "2018-10-31",
"status": "A",
"authorized_official_last_name": "LOCH",
"authorized_official_first_name": "EVELYN",
"authorized_official_title_or_position": "CREDENTIALING BILLING MANAGER",
"authorized_official_telephone_number": "703-249-9079"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.