Individual provider Active NPI

John M North, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1215977962
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
0101044050 Issued in VA
Practice address
2730-A Prosperity Avenue
Fairfax, VA 22031-4330
Phone
(703) 289-1400
Fax
(703) 289-1414
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 0101044050 VA Primary

Addresses

Primary practice location

2730-A Prosperity Avenue
Fairfax, VA 22031-4330

Mailing address

2730-B Prosperity Avenue
Fairfax, VA 22031-4330
Phone (703) 289-1400

Other identifiers 3

IdentifierTypeStateIssuer
6717811MedicaidVA
6717829MedicaidVA
6746047MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101044050VAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Neonatal Associates, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1215977962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730-B PROSPERITY AVENUE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314330",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730-A PROSPERITY AVENUE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314330",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTH",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101044050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6717811",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6717829",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6746047",
            "state": "VA"
        }
    ],
    "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 Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.