Careclix

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.123867 Issued in OH

Legal business name

CARECLIX

Practice address

1934 Old Gallows Rd
Suite 350
Vienna, VA 22182-4042

Phone

(703) 291-1285

Fax

(571) 424-1114

NPI assigned

Jan 17, 2017

Organization subpart

No

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

Authorized official

Name

Simon Kim

Title

Implementation Manager

Phone

(703) 291-1285

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1609312552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 OLD GALLOWS RD",
            "address_2": "SUITE 350",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221824042",
            "telephone_number": "703-291-1285",
            "fax_number": "571-424-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 OLD GALLOWS RD",
            "address_2": "SUITE 350",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221824042",
            "telephone_number": "703-291-1285",
            "fax_number": "571-424-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARECLIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "IMPLEMENTATION MANAGER",
        "authorized_official_telephone_number": "703-291-1285"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.123867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.