Organization Active NPI

Nova Podiatry and Wound Care Center LLC

  • Foot Surgery Podiatrist
  • Vienna, VA
National Provider Identifier
1285125930
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103301227 Issued in VA
Legal business name
NOVA PODIATRY AND WOUND CARE CENTER LLC
Practice address
1880 Howard Ave Ste 202
Vienna, VA 22182
Phone
(703) 863-9393
NPI assigned
May 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

Name
Arin AshkanNPI 1104208578
Title
Owner
Phone
(703) 651-5850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 0103301227 VA Primary

Addresses

Primary practice location

1880 Howard Ave Ste 202
Vienna, VA 22182

Mailing address

1880 Howard Ave Ste 202
Vienna, VA 22182-2611
Phone (703) 863-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180822001032 DC Part B Supplier - Clinic/Group Practice 0345599478 Receives reassigned benefits from 2 practitioners
Practice locations: Alexandria, VA; Vienna, VA

National Provider Directory

National Provider Directory

Locations

5350 Shawnee Rd
Ste 110
Alexandria, VA 22312
Phone (703) 651-5850

5350 Shawnee Rd
Alexandria, VA 22312

1880 Howard Ave
Ste 203
Vienna, VA 22182
Phone (703) 651-5850

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1285125930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 HOWARD AVE STE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822611",
            "telephone_number": "703-863-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 HOWARD AVE STE 202",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "22182",
            "telephone_number": "703-863-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PODIATRY AND WOUND CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHKAN",
        "authorized_official_first_name": "ARIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-651-5850"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103301227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.