Image Medical LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

IMAGE MEDICAL LLC

Practice address

14701 Lee Hwy
Suite 303
Centreville, VA 20121-2137

Phone

(301) 367-1666

NPI assigned

Apr 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Shirzad Alexandros Rahimi, CSA

Title

Cfo

Phone

(301) 367-1666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1295026086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 231059",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "20120",
            "telephone_number": "301-367-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 LEE HWY",
            "address_2": "SUITE 303",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212137",
            "telephone_number": "301-367-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "RAHIMI",
        "authorized_official_first_name": "SHIRZAD",
        "authorized_official_middle_name": "ALEXANDROS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-367-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Centreville, VA
• Providers in Centreville, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.