NPIMap

Organization Active NPI

Lorton Primary Care PLC

  • Pediatrics Physician
  • Lorton, VA
National Provider Identifier
1487942793
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LORTON PRIMARY CARE PLC
Practice address
7740 Gunston PLZ
Lorton, VA 22079-1897
Phone
(703) 339-5858
Fax
(703) 339-5860
NPI assigned
Jul 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Makonnen K Zelleke, M.D.
Title
President/Ceo
Phone
(703) 339-5858

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7740 Gunston PLZ
Lorton, VA 22079-1897

Mailing address

7740 Gunston PLZ
Lorton, VA 22079-1897
Phone (703) 339-5858

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1487942793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 GUNSTON PLZ",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791897",
            "telephone_number": "703-339-5858",
            "fax_number": "703-339-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 GUNSTON PLZ",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220791897",
            "telephone_number": "703-339-5858",
            "fax_number": "703-339-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORTON PRIMARY CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "ZELLEKE",
        "authorized_official_first_name": "MAKONNEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "703-339-5858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.