Active NPI
Stephanie Bolger
- Specialist
- Fairfax, VA
National Provider Identifier
1457746513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1520328
- Practice address
- 10700 Zion Dr
Fairfax, VA 22032-3432 - Phone
- (571) 451-8570
- NPI assigned
- Apr 5, 2015
- Last updated
- Apr 5, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1520328 | VA | Primary |
Addresses
Primary practice location
10700 Zion Dr
Fairfax, VA 22032-3432
Mailing address
10700 Zion Dr
Fairfax, VA 22032-3432
Phone (571) 451-8570
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1520328 | VA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428192000000",
"number": "1457746513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10700 ZION DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220323432",
"telephone_number": "571-451-8570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10700 ZION DR",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220323432",
"telephone_number": "571-451-8570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLGER",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-05",
"last_updated": "2015-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "1520328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
- Krzysztof M Bochenek, MD
- Caroline Bockus, MD
- Bodies in Motion Physical Therapy III, LLC (Bodies In Motion PT)
- Meghan Bogue, MA/CAGS
- Rosemary Cherian Bolden, MS
- Josephine Pangan Bolivar-Kerns, NP
- Bolivian Health Services LLC
- Christineb Bolognese, PHYSICAL THERAPIST
- Bom Care Inc (The Bom Home Cae)
- Sarah Bonanno, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.