Chantilly Specialists, LTD.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CHANTILLY SPECIALISTS, LTD.

Practice address

14121 Parke Long CT
Suite 112
Chantilly, VA 20151-1647

Phone

(703) 378-3854

Fax

(703) 378-4909

NPI assigned

Aug 12, 2006

Organization subpart

No

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

Authorized official

Name

Roberta Millsap

Title

Admin Assistant

Phone

(703) 378-3854

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1265444053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "address_2": "SUITE 112",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "703-378-3854",
            "fax_number": "703-378-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14121 PARKE LONG CT",
            "address_2": "SUITE 112",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511647",
            "telephone_number": "703-378-3854",
            "fax_number": "703-378-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTILLY SPECIALISTS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "MILLSAP",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "ADMIN ASSISTANT",
        "authorized_official_telephone_number": "703-378-3854"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Chantilly, VA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.