Llfaganmd LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

LLFAGANMD LLC

Practice address

1800 Town Center Dr
Suite 212
Reston, VA 20190

Phone

(703) 435-2227

Fax

(703) 435-7856

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Lynne Lillian Fagan, MD

Title

Manager

Phone

(301) 801-5886

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521849600000",
    "number": "1528143385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 MARYLAND AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162665",
            "telephone_number": "301-801-5886",
            "fax_number": "703-435-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "SUITE 212",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "20190",
            "telephone_number": "703-435-2227",
            "fax_number": "703-435-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLFAGANMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-03-24",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "LILLIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-801-5886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren S Lisse, MD
• Michael Edward Little Sr., DDS
• Frederick Liu, DDS, MD
• Liangxuan Liu
• Whitney Susan Livingston, PHD
• Kymberly Logar, LPC
• Amanda Bales Long, LCSW
• Geoffrey Stewart Long, M.D.
• Christin S Loudon, RD
• Loudoun Adult Counseling LLC

• Medical Specialty Clinic/Center in Reston, VA
• Providers in Reston, VA by specialty
• Medical Specialty Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2018; 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.