NPIMap

Organization Active NPI

NV Mental Health LLC

  • Child & Adolescent Psychiatry Physician
  • Annandale, VA
National Provider Identifier
1215288550
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
1001251635 Issued in VA
Legal business name
NV MENTAL HEALTH LLC
Practice address
5021 Backlick Rd Unit C
Annandale, VA 22003-6043
Phone
(703) 821-1434
NPI assigned
Sep 26, 2012
Last updated
Nov 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Mohammad Rafiq, MDNPI 1457563090
Title
MD
Phone
(703) 821-1434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 1001251635 VA Primary

Addresses

Primary practice location

5021 Backlick Rd Unit C
Annandale, VA 22003-6043

Mailing address

PO Box 7182
Fairfax Station, VA 22039-7182
Phone (703) 821-1434

Other identifiers 1

IdentifierTypeStateIssuer
0101251635OtherVAVA LICENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121203000138 DC Part B Supplier - Clinic/Group Practice 9436301108 Receives reassigned benefits from 1 practitioner
Practice locations: Annandale, VA

National Provider Directory

National Provider Directory

Locations

5021 Backlick Rd
#C
Annandale, VA 22003
Phone (703) 821-1434

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1215288550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7182",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220397182",
            "telephone_number": "703-821-1434",
            "fax_number": "703-821-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 BACKLICK RD UNIT C",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036043",
            "telephone_number": "703-821-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NV MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "RAFIQ",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "703-821-1434",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "1001251635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENCE",
            "identifier": "0101251635",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.