Individual provider Active NPI

Maryanne Tarkington, MD

  • Urology Physician
  • Fairfax, VA
National Provider Identifier
1407849136
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101041526 Issued in VA
Practice address
8503 Arlington Blvd
#310
Fairfax, VA 22031-4628
Phone
(703) 208-4200
Fax
(703) 876-1799
NPI assigned
Aug 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101041526 VA Primary

Addresses

Primary practice location

8503 Arlington Blvd
#310
Fairfax, VA 22031-4628

Mailing address

PO Box 327
McLean, VA 22101
Phone (703) 346-3321

Other identifiers 5

IdentifierTypeStateIssuer
502651OtherNCPPO
440309OtherANTHEM MAIN OFFICE
839434OtherAETNA
290991OtherANTEHM SATELLITE OFFICE
B131/0006OtherCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101041526VAMDUrology Physician
0101044320VAMDUrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1407849136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-346-3321",
            "fax_number": "703-356-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8503 ARLINGTON BLVD",
            "address_2": "#310",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314628",
            "telephone_number": "703-208-4200",
            "fax_number": "703-876-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARKINGTON",
        "first_name": "MARYANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101041526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "502651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MAIN OFFICE",
            "identifier": "440309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "839434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTEHM SATELLITE OFFICE",
            "identifier": "290991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "B131/0006",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.