NPIMap

Organization Active NPI

George Mason University Student Health Service

  • Student Health Clinic/Center
  • Fairfax, VA
National Provider Identifier
1336588367
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
GEORGE MASON UNIVERSITY STUDENT HEALTH SERVICE
Practice address
4400 University Dr
Ms 2 D3
Fairfax, VA 22030-4422
Phone
(703) 993-2831
Fax
(703) 993-4365
NPI assigned
Jun 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Authorized official

Name
Wagida Abdalla, M.D.
Title
Executive Director
Phone
(703) 993-2831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

4400 University Dr
Ms 2 D3
Fairfax, VA 22030-4422

Mailing address

4400 University Dr
Ms 2 D3
Fairfax, VA 22030-4422
Phone (703) 993-2831

National Provider Directory

National Provider Directory
Tax ID family
George Mason University Center for Psychological Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4400 University Dr
#2
Fairfax, VA 22030
Phone (703) 993-2831

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1336588367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 UNIVERSITY DR",
            "address_2": "MS 2 D3",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304422",
            "telephone_number": "703-993-2831",
            "fax_number": "703-993-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 UNIVERSITY DR",
            "address_2": "MS 2 D3",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304422",
            "telephone_number": "703-993-2831",
            "fax_number": "703-993-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE MASON UNIVERSITY STUDENT HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "ABDALLA",
        "authorized_official_first_name": "WAGIDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-993-2831",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "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 Jun 24, 2013; 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.