Active NPI
Jan Paul Fruiterman, MD
- Obstetrics & Gynecology Physician
- Falls Church, VA
National Provider Identifier
1295727816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 0101029267
- Practice address
- 900 S Washington St
St 300
Falls Church, VA 22046-4020 - Phone
- (703) 532-2500
- Fax
- (703) 237-1184
- NPI assigned
- Aug 19, 2005
- Last updated
- Feb 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 0101029267 | VA | Primary |
Addresses
Primary practice location
900 S Washington St
St 300
Falls Church, VA 22046-4020
Mailing address
18318 Fairway Oaks SQ
Leesburg, VA 20176-8460
Phone (571) 243-8806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6211607 | Medicaid | VA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101029267 | VA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Falls Church Medical Center LLC | Past | Accepting new patients | |
| Gentle Healthcare for Women PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Falls Church Healthcare Center
- Specialist
- Falls Church, VA
- NPI 1528275732
-
- Health Service Clinic/Center
- Falls Church, VA
- NPI 1629299128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266278400000",
"number": "1295727816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18318 FAIRWAY OAKS SQ",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201768460",
"telephone_number": "571-243-8806",
"fax_number": "703-779-1795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S WASHINGTON ST",
"address_2": "ST 300",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220464020",
"telephone_number": "703-532-2500",
"fax_number": "703-237-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRUITERMAN",
"first_name": "JAN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2010-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VA",
"license": "0101029267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6211607",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.