NPIMap

Organization Active NPI

Fairfax Family Practice Centers PC

Doing business as Town Center Family Medicine

  • Family Medicine Physician
  • Reston, VA
National Provider Identifier
1417071697
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAIRFAX FAMILY PRACTICE CENTERS PC
Doing business as
Town Center Family Medicine
Practice address
12110 Sunset Hills Road
Lower Level 20
Reston, VA 20190
Phone
(703) 834-1473
Fax
(703) 318-7463
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
James P Jenkins, MD
Title
President
Phone
(703) 255-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12110 Sunset Hills Road
Lower Level 20
Reston, VA 20190

Mailing address

PO Box 791128
Baltimore, MD 21279-1128
Phone (703) 834-1473

Other names 1

  • Town Center Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fairfax Family Prac Cen10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12110 Sunset Hills Rd
Lowr
Reston, VA 20190
Phone (703) 834-1473

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1417071697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791128",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791128",
            "telephone_number": "703-834-1473",
            "fax_number": "703-318-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 SUNSET HILLS ROAD",
            "address_2": "LOWER LEVEL 20",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-834-1473",
            "fax_number": "703-318-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX FAMILY PRACTICE CENTERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-255-9100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Center Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 26, 2007; 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.