NPIMap

Organization Active NPI

Compassus Op of Virginia LLC

Doing business as Compassus Palliative Care Consultation Program - Reston

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Chantilly, VA
National Provider Identifier
1689119877
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
COMPASSUS OP OF VIRGINIA LLC
Doing business as
Compassus Palliative Care Consultation Program - Reston
Practice address
14900 Conference Center Dr Ste 170
Chantilly, VA 20151-3831
Phone
(703) 468-2740
Fax
(703) 754-8026
NPI assigned
Dec 27, 2016
Last updated
Feb 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QH0002X Primary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0002X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

14900 Conference Center Dr Ste 170
Chantilly, VA 20151-3831

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022

Other names 1

  • Compassus Palliative Care Consultation Program - Reston Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171019002455 DC Part B Supplier - Clinic/Group Practice 7012284664 Receives reassigned benefits from 4 practitioners
Practice locations: Chantilly, VA
O20200630002764 VA Part B Supplier - Clinic/Group Practice 7012284664 Receives reassigned benefits from 4 practitioners
Practice locations: Chantilly, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Compassus - Reston4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

521 N Quincy St
Arlington, VA 22203
Phone 70384107033005

8110 Gatehouse Rd
Ste 300W
Falls Church, VA 22042
Phone (703) 205-2214

Practitioners & affiliated clinicians

Practitioners 5

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": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1689119877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "615-377-7022",
            "fax_number": "615-373-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 CONFERENCE CENTER DR STE 170",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513831",
            "telephone_number": "703-468-2740",
            "fax_number": "703-754-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSUS OP OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus Palliative Care Consultation Program - Reston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Compassus Palliative Care Consultation Program - Reston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.