Active NPI
Fairfax Urgent Care LLC
- General Practice Physician
- Falls Church, VA
National Provider Identifier
1376823237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- FAIRFAX URGENT CARE LLC
- Practice address
- 8191 Strawberry LN
4
Falls Church, VA 22042-1031 - Phone
- (703) 658-2650
- NPI assigned
- Aug 24, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ambrish Gupta, M.D.
- Title
- Manager
- Phone
- (703) 658-2650
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
8191 Strawberry LN
4
Falls Church, VA 22042-1031
Mailing address
8191 Strawberry LN
4
Falls Church, VA 22042-1031
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111102000584 | DC | Part B Supplier - Clinic/Group Practice | 5991978215 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment Practice locations: Falls Church, VA |
National Provider Directory
National Provider Directory- Tax ID family
- Fairfax Urgent Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urgent Care Clinic/Center
- Falls Church, VA
- NPI 1376402917
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320192000000",
"number": "1376823237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8191 STRAWBERRY LN",
"address_2": "4",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220421031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8191 STRAWBERRY LN",
"address_2": "4",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220421031",
"telephone_number": "703-658-2650"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRFAX URGENT CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-08-24",
"last_updated": "2011-11-02",
"status": "A",
"authorized_official_last_name": "GUPTA",
"authorized_official_first_name": "AMBRISH",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "703-658-2650",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Nov 2, 2011; 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.