Individual provider Active NPI

Adrienne M Law

  • Family Medicine Physician
  • Fairfax, VA
National Provider Identifier
1699296459
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102206618 Issued in VA
Practice address
3650 Joseph Siewick Dr Ste 101
Fairfax, VA 22033-1700
Phone
(703) 391-2020
Fax
(703) 391-1211
NPI assigned
Jul 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116030980 VA
Family Medicine Physician 207Q00000X 0102206618 VA Primary

Addresses

Primary practice location

3650 Joseph Siewick Dr Ste 101
Fairfax, VA 22033-1700

Mailing address

9142 Richmond Hwy Apt 447
Fort Belvoir, VA 22060-1355

Other practice location 1

9300 DeWitt Loop
Fort Belvoir, VA 22060-5285
Phone (612) 205-4328

Other identifiers 1

IdentifierTypeStateIssuer
0116030980OtherVAVIRGINIA BOARD OF MEDICINE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220420001759 CA Practitioner - Family Practice 1557697711 Reassigns benefits to 1 organization
I20230411000566 DC Practitioner - Family Practice 1557697711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

400 Craven Rd
San Marcos, CA 92078-4201
Phone (619) 528-5000

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0116030980VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC Family Medicine CurrentSince Feb 5, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 12, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 12, 2022 Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3650 Joseph Siewick Dr
Ste 400
Fairfax, VA 22033
Phone (703) 391-2020

3650 Joseph Siewick Dr
Ste 101
Fairfax, VA 22033
Phone (703) 391-0900

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1699296459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9142 RICHMOND HWY APT 447",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220601355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 JOSEPH SIEWICK DR STE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331700",
            "telephone_number": "703-391-2020",
            "fax_number": "703-391-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 DeWitt Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Belvoir",
            "state": "VA",
            "postal_code": "220605285",
            "country_code": "US",
            "telephone_number": "612-205-4328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAW",
        "first_name": "ADRIENNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116030980",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102206618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF MEDICINE",
            "identifier": "0116030980",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.