Viv Fairfax, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

VIV FAIRFAX, LLC

Practice address

13135 Lee Jackson Memorial Hwy Ste 145
Fairfax, VA 22033-1907

Phone

(215) 828-2387

NPI assigned

Apr 22, 2021

Last updated

Apr 22, 2021By 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

Dr. Anish P Shah, MDNPI 1699790436

Title

Ceo

Phone

(215) 828-2387

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anish P Shah, MD

  • Nephrology Physician
  • Woodbridge, VA
  • NPI 1699790436
  NPD Authorized official

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1396327052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14085 CROWN CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931458",
            "telephone_number": "703-763-5224",
            "fax_number": "703-763-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13135 LEE JACKSON MEMORIAL HWY STE 145",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331907",
            "telephone_number": "215-828-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIV FAIRFAX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ANISH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-828-2387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Rebecca Vitale, NP
• Vitality Home Health
• Vitalityhome Healthcare, LLC
• Vitas Healthcare Corporation Atlantic
• Vitas Healthcare Corporation Atlantic
• Katalin Vizy
• Laura Vizy
• Hong P Vo, M.D
• Terri H Vo, OD
• Thuy Phuong Thi Vo, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fairfax, VA
• Providers in Fairfax, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.