Organization Active NPI

Tele Health Practice

  • Medical Specialty Clinic/Center
  • Fairfax, VA
National Provider Identifier
1417546953
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
TELE HEALTH PRACTICE
Practice address
9513 Blake LN Apt 204
Fairfax, VA 22031-1716
Phone
(443) 985-6253
NPI assigned
Jan 11, 2021
Last updated
Jan 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Aveen SaedNPI 1588253033
Title
Provider
Phone
(443) 985-6253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

9513 Blake LN Apt 204
Fairfax, VA 22031-1716

Mailing address

9513 Blake LN Apt 204
Fairfax, VA 22031-1716

Other identifiers 1

IdentifierTypeStateIssuer
058649751MedicaidCA

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL FAIRFAX
Other URL FAIRFAX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1417546953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 BLAKE LN APT 204",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 BLAKE LN APT 204",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220311716",
            "telephone_number": "443-985-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELE HEALTH PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "SAED",
        "authorized_official_first_name": "AVEEN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "443-985-6253"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058649751",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "FAIRFAX",
            "affiliation": "N",
            "address_1": "9513 Blake Ln Apt 204",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220311716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "FAIRFAX",
            "affiliation": "N",
            "address_1": "9513 Blake Ln Apt 204",
            "city": "Fairfax",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220311716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 11, 2021; 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.