NPIMap

Organization Active NPI

Dominion Cardiovascular Associates, P.C.

  • Cardiovascular Disease Physician
  • Lake Ridge, VA
National Provider Identifier
1619236304
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101058310 Issued in VA
Legal business name
DOMINION CARDIOVASCULAR ASSOCIATES, P.C.
Practice address
12710 Darby Brook CT
Lake Ridge, VA 22192-2486
Phone
(703) 496-4190
Fax
(866) 239-6997
NPI assigned
May 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Dr. Jun Anthony Ventura Quion, M.D. FACCNPI 1356332050
Title
President
Phone
(703) 346-6388

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 0101058310 VA Primary

Addresses

Primary practice location

12710 Darby Brook CT
Lake Ridge, VA 22192-2486

Mailing address

PO Box 5433
MC Lean, VA 22103-5433
Phone (703) 346-6388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120730000046 VA Part B Supplier - Clinic/Group Practice 2860658275 Receives reassigned benefits from 2 practitioners
Practice locations: Manassas, VA
O20130723000383 DC Part B Supplier - Clinic/Group Practice 2860658275 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, VA

National Provider Directory

National Provider Directory

Locations

3299 Woodburn Rd
Ste 360
Annandale, VA 22003
Phone (703) 204-2706

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11138/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1619236304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5433",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221035433",
            "telephone_number": "703-346-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12710 DARBY BROOK CT",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922486",
            "telephone_number": "703-496-4190",
            "fax_number": "866-239-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION CARDIOVASCULAR ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "QUION",
        "authorized_official_first_name": "JUN ANTHONY",
        "authorized_official_middle_name": "VENTURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-346-6388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. FACC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101058310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.