NPIMap

Organization Active NPI

Chantilly Specialists, LTD. of Virginia

  • Pain Medicine Physician
  • Chantilly, VA
National Provider Identifier
1497079073
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
CHANTILLY SPECIALISTS, LTD. OF VIRGINIA
Practice address
4200 Lafayette Center Dr
Ste R
Chantilly, VA 20151-1241
Phone
(703) 378-3854
Fax
(703) 378-4909
NPI assigned
Mar 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Mr. Paul Boccone, J.D., LL.M.
Title
President
Phone
(703) 378-3854

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

4200 Lafayette Center Dr
Ste R
Chantilly, VA 20151-1241

Mailing address

4200 Lafayette Center Dr
Ste R
Chantilly, VA 20151-1241
Phone (703) 378-3854

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1497079073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 LAFAYETTE CENTER DR",
            "address_2": "STE R",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511241",
            "telephone_number": "703-378-3854",
            "fax_number": "703-378-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 LAFAYETTE CENTER DR",
            "address_2": "STE R",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511241",
            "telephone_number": "703-378-3854",
            "fax_number": "703-378-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTILLY SPECIALISTS, LTD. OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "BOCCONE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-378-3854",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D., LL.M."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.