Fairfax Family Practice Centers, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAIRFAX FAMILY PRACTICE CENTERS, P.C.

Doing business as

Family Medicine of Clifton-Centreville

Practice address

6201 Centreville Rd Ste 100
Centreville, VA 20121-2626

Phone

(703) 263-9600

Fax

(703) 266-1452

NPI assigned

Oct 24, 2006

Last updated

Feb 21, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

FAIRFAX FAMILY PRACTICE CENTERS, PCAs reported in NPPES

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

Authorized official

Name

Dr. James P. Jenkins Jr., MD

Title

President

Phone

(703) 391-2030

Specialties & licenses 2

Addresses

Other identifiers 17

Other names 1

• Family Medicine of Clifton-Centreville Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Fairfax Family Practice

Locations

Practitioners 11

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.

• Janine R Brown, MD

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1699771394
  NPD (past)
• William H Carter, MD

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1164428801
  NPD (past)
• Lenore L Day, M.D.

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1245236926
  NPD (past)
• Emily Faltemier, MD

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1770759524
  NPD (past)
• Brigid C Gray, MD

  • Hospitalist Physician
  • Falls Church, VA
  • NPI 1093741035
  NPD (past)
• Catherine Ann Groff, CFNP

  • Family Nurse Practitioner
  • Centreville, VA
  • NPI 1215062302
  NPD (past)
• Julie F Overholtzer, M.D.

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1790781474
  NPD (past)
• Rex B Ruiz, MD

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1063418762
  NPD (past)
• Thomas S Sullivan, M.D.

  • Family Medicine Physician
  • Reston, VA
  • NPI 1295742419
  NPD (past)
• Jeffry T Waldman, MD

  • Family Medicine Physician
  • Centreville, VA
  • NPI 1548266117
  NPD (past)
• Matthew M Borges, PA

  • Medical Physician Assistant
  • Houston, TX
  • NPI 1588830640
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1710060330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791128",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791128",
            "telephone_number": "703-391-2030",
            "fax_number": "703-273-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 CENTREVILLE RD STE 100",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212626",
            "telephone_number": "703-263-9600",
            "fax_number": "703-266-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX FAMILY PRACTICE CENTERS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAIRFAX FAMILY PRACTICE CENTERS, PC",
        "enumeration_date": "2006-10-24",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-391-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0631926",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548266117",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1699771394",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5618916",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICARE",
            "identifier": "CO8267",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HIGHMARK",
            "identifier": "G00522",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487657136",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010072409",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790781474",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5618959",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205944964",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245236926",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5604761",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5619181",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "11664428801",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5619050",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5619076",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063418762",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine of Clifton-Centreville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wayne Richard Eriksson, MD
• Maria C Espinal
• Ashley M F Estes
• Antonia Evans, NP-C
• Everyone Inc.
• Fairfax Radiological Consultants PC
• Beverly Fajardo
• Falbo & Thomas, DDS
• Anthony D Falbo, DDS
• Emily Faltemier, MD

• Family Medicine Physician in Centreville, VA
• Providers in Centreville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.