NPIMap

Organization Active NPI

Cardiac Care Associates PC

  • Cardiovascular Disease Physician
  • Fairfax, VA
National Provider Identifier
1649381724
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIAC CARE ASSOCIATES PC
Practice address
3023 Hamaker CT
Suite #100
Fairfax, VA 22031
Phone
(703) 641-9161
Fax
(703) 641-0383
NPI assigned
Aug 31, 2006
Last updated
Dec 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Authorized official

Name
Dr. Kenneth M Brooks, MDNPI 1073604435
Title
MD Managing Partner
Phone
(703) 641-9161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

3023 Hamaker CT
Suite #100
Fairfax, VA 22031

Mailing address

3023 Hamaker Court
Suite #100
Fairfax, VA 22031
Phone (703) 641-9161

Other identifiers 1

IdentifierTypeStateIssuer
DA1708OtherVARAIL ROAD MEDICARE ID

National Provider Directory

National Provider Directory

Locations

2415 Musgrove Rd
Ste 102
Silver Spring, MD 20904

3023 Hamaker Ct
Ste 100
Fairfax, VA 22031
Phone (703) 641-9161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1649381724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER COURT",
            "address_2": "SUITE #100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-641-9161",
            "fax_number": "703-641-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 HAMAKER CT",
            "address_2": "SUITE #100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-641-9161",
            "fax_number": "703-641-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC CARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD MANAGING PARTNER",
        "authorized_official_telephone_number": "703-641-9161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE ID",
            "identifier": "DA1708",
            "state": "VA"
        }
    ],
    "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 Dec 22, 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.