Active NPI
Shirzad Alexdandros Rahimi, CSA
- Surgical Assistant
- Centreville, VA
National Provider Identifier
1417201401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 14701 Lee Highway
Suite 303
Centreville, VA 20121-2137 - Phone
- (301) 502-9680
- NPI assigned
- Oct 30, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
14701 Lee Highway
Suite 303
Centreville, VA 20121-2137
Mailing address
14701 Lee Hwy
Suite 303
Centreville, VA 20121-2137
Phone (301) 502-9680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000000 | Other | VA | BCBS, CIGNA, UNITED HEALTHCARE, CARE FIRST |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1417201401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14701 LEE HWY",
"address_2": "SUITE 303",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201212137",
"telephone_number": "301-502-9680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14701 LEE HIGHWAY",
"address_2": "SUITE 303",
"city": "CENTREVILLE",
"state": "VA",
"postal_code": "201212137",
"telephone_number": "301-502-9680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHIMI",
"first_name": "SHIRZAD",
"middle_name": "ALEXDANDROS",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-30",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS, CIGNA, UNITED HEALTHCARE, CARE FIRST",
"identifier": "0000000000",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.