Individual provider Active NPI

Dennis L. Fair, P.A.C.

  • Physician Assistant
  • Stafford, VA
National Provider Identifier
1629074331
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001215 Issued in VA
Practice address
422 Garrisonville Rd
Ste 111
Stafford, VA 22554-1573
Phone
(540) 657-9441
Fax
(540) 657-4366
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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 0110001215 VA Primary

Addresses

Primary practice location

422 Garrisonville Rd
Ste 111
Stafford, VA 22554-1573

Mailing address

PO Box 729
Garrisonville, VA 22463-0729
Phone (540) 657-9441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050428000175 VA Practitioner - Physician Assistant 2668411760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Washington Healthcare PhysiciansGroup PAC ID 2769546530, 286 clinicians

Practice addresses (Care Compare)

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1100

2300 Fall Hill Ave
Suite 308
Fredericksburg, VA 22401-3343

4548 Empire CT
Fredericksburg, VA 22408-1939
Phone (540) 374-3150

Hospital & facility affiliations

  • Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110001215VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Jan 4, 2016 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Jan 4, 2016 Accepting new patients

Locations

10620 Spotsylvania Ave
Fredericksburg, VA 22408
Phone (540) 374-3150

4548 Empire Ct
Fredericksburg, VA 22408
Phone (540) 373-2244

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

Interoperability endpoints

  • Direct secure messaging: dfair12115@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1629074331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "GARRISONVILLE",
            "state": "VA",
            "postal_code": "224630729",
            "telephone_number": "540-657-9441",
            "fax_number": "540-657-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 GARRISONVILLE RD",
            "address_2": "STE 111",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541573",
            "telephone_number": "540-657-9441",
            "fax_number": "540-657-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "DENNIS",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.