Organization Active NPI

Capitol Rehab Annandale, Inc.

  • Chiropractor
  • Annandale, VA
National Provider Identifier
1699832782
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556483 Issued in VA
Legal business name
CAPITOL REHAB ANNANDALE, INC.
Practice address
6940A Bradlick Shopping Ctr
Annandale, VA 22003-7205
Phone
(703) 333-5022
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Mohammad Reza Komaily, DC
Title
President
Phone
(703) 333-5022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 0104556483 VA Primary

Addresses

Primary practice location

6940A Bradlick Shopping Ctr
Annandale, VA 22003-7205

Mailing address

6940A Bradlick Shopping Ctr
Annandale, VA 22003-7205
Phone (703) 333-5022

Other identifiers 2

IdentifierTypeStateIssuer
1487735007OtherVANPI - DR. MO KOMAILY
1245391226OtherVANPI - DR JEREMY SCHMIDT

National Provider Directory

National Provider Directory

Locations

6940A Bradlick Shopping Ctr
Annandale, VA 22003
Phone (703) 333-5022

6940A Braddock Rd
Annandale, VA 22003
Phone (703) 333-5022

Practitioners & affiliated clinicians

Practitioners 1

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1699832782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940A BRADLICK SHOPPING CTR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220037205",
            "telephone_number": "703-333-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940A BRADLICK SHOPPING CTR",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220037205",
            "telephone_number": "703-333-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL REHAB ANNANDALE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "KOMAILY",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-333-5022",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - DR. MO KOMAILY",
            "identifier": "1487735007",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - DR JEREMY SCHMIDT",
            "identifier": "1245391226",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.