Organization Active NPI

Regional Health Providers LLC

  • Addiction Medicine (Family Medicine) Physician
  • Fairfax, VA
National Provider Identifier
1154898997
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
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

Updated by the provider on Oct 31, 2018

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)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2171677Regional Health Providers, LLC3917 Old Lee Hwy, Suite 11D, Fairfax, VA 22030Certificate of waiverSep 5, 2027

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.