Chantilly Rehab Physicians PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101238655 Issued in VA

Legal business name

CHANTILLY REHAB PHYSICIANS PC

Practice address

24430 Millstream Dr
Aldie, VA 20105-3098

Phone

(703) 991-9778

NPI assigned

Jun 20, 2011

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shaik Samdani, MD

Title

President

Phone

(703) 991-9778

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1326334244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2207",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220310207",
            "telephone_number": "703-991-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24430 MILLSTREAM DR",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201053098",
            "telephone_number": "703-991-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTILLY REHAB PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "SAMDANI",
        "authorized_official_first_name": "SHAIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-991-9778",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101238655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437118437",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Aldie, VA
• Providers in Aldie, VA by specialty
• Physical Medicine & Rehabilitation Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.