Individual provider Active NPI

Timothy T Huynh, A.T.C.

  • Athletic Trainer
  • Fairfax, VA
National Provider Identifier
1275987570
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0126002382 Issued in VA
Practice address
4500 Patriot Cir
Fairfax, VA 22030-4468
Phone
(703) 993-3279
NPI assigned
Apr 22, 2016
Last updated
Apr 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126002382 VA Primary

Addresses

Primary practice location

4500 Patriot Cir
Fairfax, VA 22030-4468

Mailing address

13392 Caballero Way
Clifton, VA 20124-1004
Phone (703) 994-9197

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

State licenses

LicenseStateTypeSpecialty
0126002382VAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1275987570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13392 CABALLERO WAY",
            "city": "CLIFTON",
            "state": "VA",
            "postal_code": "201241004",
            "telephone_number": "703-994-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PATRIOT CIR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304468",
            "telephone_number": "703-993-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "TIMOTHY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126002382",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2016; 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.