Organization Active NPI

Prachak T Siriprakorn M.D. P.C.

  • Cardiovascular Disease Physician
  • Woodbridge, VA
National Provider Identifier
1407094428
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PRACHAK T SIRIPRAKORN M.D. P.C.
Practice address
1966 Opitz Blvd
Woodbridge, VA 22191-3304
Phone
(703) 491-2179
Fax
(703) 491-4532
NPI assigned
Jan 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Authorized official

Name
Dr. Prachak T Siriprakorn, M.D.
Title
Physician
Phone
(703) 491-2179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1966 Opitz Blvd
Woodbridge, VA 22191-3304

Mailing address

1966 Opitz Blvd
Woodbridge, VA 22191-3304
Phone (703) 491-2179

Other identifiers 1

IdentifierTypeStateIssuer
438917OtherVAMEDICARE, CAMP HILL, PA

National Provider Directory

National Provider Directory

Locations

1966 Opitz Blvd
#9
Woodbridge, VA 22191
Phone (703) 491-2179

Practitioners & affiliated clinicians

Practitioners 1

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": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1407094428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913304",
            "telephone_number": "703-491-2179",
            "fax_number": "703-491-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1966 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913304",
            "telephone_number": "703-491-2179",
            "fax_number": "703-491-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACHAK T SIRIPRAKORN M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "SIRIPRAKORN",
        "authorized_official_first_name": "PRACHAK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-491-2179",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, CAMP HILL, PA",
            "identifier": "438917",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.