Organization Active NPI

Greenfield Assisted Living of Stafford LLC

  • Assisted Living Facility
  • Falls Church, VA
National Provider Identifier
1235536608
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
WLO-05-1103730 Issued in VA
Legal business name
GREENFIELD ASSISTED LIVING OF STAFFORD LLC
Practice address
6312 Seven Corners Center #161
Falls Church, VA 22044
Phone
(703) 962-9125
Fax
(703) 237-5609
NPI assigned
Dec 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Authorized official

Name
Mathew Peponis
Title
Ceo
Phone
(703) 962-9125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X WLO-05-1103730 VA Primary

Addresses

Primary practice location

6312 Seven Corners Center #161
Falls Church, VA 22044

Mailing address

30 Kings Crest Drive
Stafford, VA 22554
Phone (540) 288-9353

Other names 1

  • Greenfield Assisted Living of Stafford Doing business as

National Provider Directory

National Provider Directory

Locations

6312 Seven Corners Ctr
Falls Church, VA 22044
Phone (202) 643-5571

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1235536608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KINGS CREST DRIVE",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "540-288-9353",
            "fax_number": "540-288-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 SEVEN CORNERS CENTER #161",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22044",
            "telephone_number": "703-962-9125",
            "fax_number": "703-237-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENFIELD ASSISTED LIVING OF STAFFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "PEPONIS",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "703-962-9125"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VA",
            "license": "WLO-05-1103730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenfield Assisted Living of Stafford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.