Organization Active NPI

City of Fairfax

  • Ambulance
  • Fairfax, VA
National Provider Identifier
1194911099
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
72 Issued in VA
Legal business name
CITY OF FAIRFAX
Practice address
4081 University Dr Ste 400
Fairfax, VA 22030-3407
Phone
(703) 385-7940
Fax
(703) 273-9257
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
John O'Neal
Title
Fire Chief
Phone
(937) 291-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 72 VA Primary

Addresses

Primary practice location

4081 University Dr Ste 400
Fairfax, VA 22030-3407

Mailing address

PO Box 5211
Dept # 116256
Binghamton, NY 13902-5211
Phone (703) 385-7940

Other names 1

  • City of Fairfax Fire Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080324000502 DC Part B Supplier - Ambulance Service Supplier 0042396657 Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory
Tax ID family
City of Fairfax2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4081 University Dr
Ste 400
Fairfax, VA 22030
Phone (703) 385-7940

10101 Fairfax Blvd
Fairfax, VA 22030
Phone (703) 385-7941

4081 University Dr
Fairfax, VA 22030
Phone (703) 385-7940

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1194911099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5211",
            "address_2": "DEPT # 116256",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139025211",
            "telephone_number": "703-385-7940",
            "fax_number": "703-273-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4081 UNIVERSITY DR STE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303407",
            "telephone_number": "703-385-7940",
            "fax_number": "703-273-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FAIRFAX",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "937-291-2892"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "72",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City of Fairfax Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.