Continental Dialysis Center of Springfield Fairfax Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

CONTINENTAL DIALYSIS CENTER OF SPRINGFIELD FAIRFAX INC

Doing business as

CDC of Springfield

Practice address

8003 Forbes PL Ste 110
Springfield, VA 22151-2215

Phone

(703) 321-7207

Fax

(703) 321-8658

NPI assigned

Apr 14, 2006

Last updated

Jun 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensure & Certificaiton

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CDC of Springfield Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

DaVita CDC-SpringfieldCCN 492535

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Nov 1, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

21

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Nam Nhat Ha, MD

  • Nephrology Physician
  • Fairfax, VA
  • NPI 1659863124

  Dialysis facility

  Care Compare affiliation Name & address match
• Ahmadshah Mirkhel, M.D.

  • Nephrology Physician
  • Fairfax, VA
  • NPI 1790729317

  Dialysis facility

  Care Compare affiliation Name & address match
• Kevin Thomas Harley, M.D.

  • Nephrology Physician
  • Orange, CA
  • NPI 1194924100

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1245294230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8003 FORBES PL STE 110",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512215",
            "telephone_number": "703-321-7207",
            "fax_number": "703-321-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTINENTAL DIALYSIS CENTER OF SPRINGFIELD FAIRFAX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSURE & CERTIFICAITON",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4925351",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDC of Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Comprehensive Health and Behavioral Services LLC (Comprehensive Home Health)
• Sarah Spengler Compton, PT
• Khatuna Conlon
• Beth Lynn Connors, AUD
• Laurie A Conran
• Lynn Converse
• Laura A Conway, NP
• Andrew Cook
• Marlana Cooley, LPN
• James Mark Cooper, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Springfield, VA
• Providers in Springfield, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.