Individual provider Active NPI

John Fano Schultze, PA

  • Physician Assistant
  • Falls Church, VA
National Provider Identifier
1548363609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002281 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-3111
Fax
(904) 346-0113
NPI assigned
Sep 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002281 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

PO Box 759101
Batimore, MA 21275
Phone (703) 205-9790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110303000243 TN Practitioner - Physician Assistant 6901808732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Physicians Practice LLCGroup PAC ID 2163490319, 33 clinicians

Practice addresses (Care Compare)

705 Cook Dr
Athens, TN 37303-3494

719 Cook Dr
Athens, TN 37303-3495

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110002281VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Physicians Practice LLC CurrentSince Jul 1, 2024 Accepting new patients
Athens Physicians Practice LLC CurrentSince Jul 1, 2024 Accepting new patients
Athens Physicians Practice LLC Past Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Bestpractices, Inc. Past Accepting new patients
Bestpractices, Inc. Past Accepting new patients

Locations

705 Cook Dr
Ste 203
Athens, TN 37303
Phone (423) 744-1300

719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770

872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585

Interoperability endpoints

  • Direct secure messaging: john.fano-schultze.1@19363.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548363609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 759101",
            "city": "BATIMORE",
            "state": "MA",
            "postal_code": "21275",
            "telephone_number": "703-205-9790",
            "fax_number": "904-596-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-3111",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANO SCHULTZE",
        "first_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.