NPIMap

Organization Active NPI

Ear Nose and Throat and Facial Plastic Surgery Center of Frederick

  • Otolaryngology Physician
  • Fredericksburg, VA
National Provider Identifier
1164517314
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR NOSE AND THROAT AND FACIAL PLASTIC SURGERY CENTER OF FREDERICK
Practice address
1708 Fall Hill Ave
Suite 100
Fredericksburg, VA 22401-3511
Phone
(540) 371-1226
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Caleb Massey, M.D.
Title
Managing Physician
Phone
(540) 371-1226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

1708 Fall Hill Ave
Suite 100
Fredericksburg, VA 22401-3511

Mailing address

1708 Fall Hill Ave
Suite 100
Fredericksburg, VA 22401-3511

Other identifiers 1

IdentifierTypeStateIssuer
CD7365OtherVAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070321000690 VA Part B Supplier - Clinic/Group Practice 5496858979 Receives reassigned benefits from 26 practitioners
Practice locations: Fredericksburg, VA; Stafford, VA

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
49D2342776ENT & Facial Plastic Surgery Center1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory

Locations

4701 Spotsylvania Pkwy
Ste 100
Fredericksburg, VA 22407
Phone (540) 371-1226

1708 Fall Hill Ave
Ste 100
Fredericksburg, VA 22401
Phone (540) 371-1226

282 Choptank Rd
Ste 100
Stafford, VA 22556
Phone (540) 371-1226

282 Choptank Rd
Ste 107
Stafford, VA 22556
Phone (540) 371-1263

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1164517314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 FALL HILL AVE",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 FALL HILL AVE",
            "address_2": "SUITE 100",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013511",
            "telephone_number": "540-371-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE AND THROAT AND FACIAL PLASTIC SURGERY CENTER OF FREDERICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "540-371-1226",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CD7365",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.