Organization Active NPI

The Gastroenterology Center of Virginia, PLLC

  • Ambulatory Surgical Clinic/Center
  • Reston, VA
National Provider Identifier
1396771036
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC
Practice address
11440 Commerce Park Dr
Suite LL-4
Reston, VA 20191-1555
Phone
(703) 766-2600
Fax
(703) 766-2604
NPI assigned
Jun 24, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Dr. R. Allen Blosser, MD
Title
President
Phone
(703) 766-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

11440 Commerce Park Dr
Suite LL-4
Reston, VA 20191-1555

Mailing address

11440 Commerce Park Dr
Suite LL-4
Reston, VA 20191-1555
Phone (703) 766-2600

National Provider Directory

National Provider Directory

Locations

11440 Commerce Park Dr
Ste LL4
Reston, VA 20191
Phone (703) 766-2600

1800 Alexander Bell Dr
Ste 515
Reston, VA 20191
Phone (703) 535-6640

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1396771036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11440 COMMERCE PARK DR",
            "address_2": "SUITE LL-4",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911555",
            "telephone_number": "703-766-2600",
            "fax_number": "703-766-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 COMMERCE PARK DR",
            "address_2": "SUITE LL-4",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911555",
            "telephone_number": "703-766-2600",
            "fax_number": "703-766-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "BLOSSER",
        "authorized_official_first_name": "R. ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-766-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.