Organization Active NPI

Childrens National Specialist of Virginia LLC

  • Pediatrics Physician
  • Fairfax, VA
National Provider Identifier
1639304918
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
HFD01-0208 Issued in DC
Legal business name
CHILDRENS NATIONAL SPECIALIST OF VIRGINIA LLC
Practice address
3023 Hamaker Court
Suite 500
Fairfax, VA 22031
Phone
(202) 476-6284
NPI assigned
May 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Ms. Susan Pfennig
Title
Manager
Phone
(202) 476-4447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X HFD01-0208 DC Primary

Addresses

Primary practice location

3023 Hamaker Court
Suite 500
Fairfax, VA 22031

Mailing address

PO Box 17507
Baltimore, MD 21297-0483

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1639304918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17507",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212970483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER COURT",
            "address_2": "SUITE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "202-476-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS NATIONAL SPECIALIST OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "PFENNIG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "202-476-4447",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "HFD01-0208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.