Active NPI
Prachak T Siriprakorn M.D. P.C.
- Cardiovascular Disease Physician
- Woodbridge, VA
National Provider Identifier
1407094428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 438917 | Other | VA | MEDICARE, CAMP HILL, PA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Internal Medicine Physician
- Woodbridge, VA
- NPI 1619986940
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.