Sunrise Family Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

BB7494901 Issued in VA

Legal business name

SUNRISE FAMILY MEDICAL CENTER

Practice address

12359 Sunrise Valley Dr Ste 200
Reston, VA 20191-3493

Phone

(703) 476-9300

Fax

(703) 476-9304

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Ahmad Baray

Title

MD

Phone

(703) 476-9300

Specialties & licenses 1

Addresses

Other identifiers 8

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1689841850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 200",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913493",
            "telephone_number": "703-476-9300",
            "fax_number": "703-476-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12359 SUNRISE VALLEY DR STE 200",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913493",
            "telephone_number": "703-476-9300",
            "fax_number": "703-476-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "BARAY",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "703-476-9300"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "BB7494901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "106459",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4127655",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "J738-0001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5763643",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1999094",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G01498",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010044481",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "297400",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Reston, VA
• Providers in Reston, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.