Professional Management Services, LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

PROFESSIONAL MANAGEMENT SERVICES, LLC

Practice address

6138 Redwood Square Ctr
Suite 204
Centreville, VA 20121-4264

Phone

(703) 229-5453

Fax

(888) 352-8653

NPI assigned

May 22, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Birgit Gabriele Whyard

Title

Director of Operations

Phone

(703) 229-5453

Specialties & licenses 10

Addresses

Other names 1

• Virginia Addiction Medicine Doing business as

Locations

Practitioners 2

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

• Su Fairchild, MD

  • Family Medicine Physician
  • Winchester, VA
  • NPI 1861488074

  Addiction Medicine

  NPD (past)
• Emily T Keenan, CRNP-F

  • Family Nurse Practitioner
  • Winchester, VA
  • NPI 1154476612
  NPD (past)

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633478400000",
    "number": "1356720437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 VALLEY AVE",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012755",
            "telephone_number": "703-229-5453",
            "fax_number": "888-352-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6138 REDWOOD SQUARE CTR",
            "address_2": "SUITE 204",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201214264",
            "telephone_number": "703-229-5453",
            "fax_number": "888-352-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MANAGEMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "WHYARD",
        "authorized_official_first_name": "BIRGIT",
        "authorized_official_middle_name": "GABRIELE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "703-229-5453",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Addiction Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virginia Addiction Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Lactation Services, LLC
• Prime Orthodontics PLLC
• Prime Ride LLC
• Primecare Support Services LLC
• Primus Physical Therapy
• Professional Sportscare & Rehab, LLC
• Jayeeta Purkayastha
• Michelle Yeonjung Pyen, NP-BC
• Yong Uk Pyun
• Richard M Quinn, DPT

• Addiction Medicine (Family Medicine) Physician in Centreville, VA
• Providers in Centreville, VA by specialty
• Addiction Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.