Organization Active NPI

Cardiac and Vascular Care of Virginia, P.C.

  • Interventional Cardiology Physician
  • Annandale, VA
National Provider Identifier
1720204936
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
0101052912 Issued in VA
Legal business name
CARDIAC AND VASCULAR CARE OF VIRGINIA, P.C.
Practice address
3301 Woodburn Road
Suite 101
Annandale, VA 22003-6890
Phone
(703) 573-0800
Fax
(703) 573-8809
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Dr. Albert H. Kim, M.D.NPI 1780682583
Title
President
Phone
(703) 573-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0011X 0101052912 VA Primary

Addresses

Primary practice location

3301 Woodburn Road
Suite 101
Annandale, VA 22003-6890

Mailing address

3301 Woodburn Road
Suite 101
Annandale, VA 22003-6890
Phone (703) 573-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000323 DC Part B Supplier - Clinic/Group Practice 1355311549 Receives reassigned benefits from 1 practitioner
Practice locations: Annandale, VA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2003563Cardiac and Vascular Care of Virginia, PC3301 Woodburn Road - Suite 101, Annandale, VA 22003Certificate of waiverFeb 10, 2028

National Provider Directory

National Provider Directory

Locations

3301 Woodburn Rd
Ste 101
Annandale, VA 22003
Phone (703) 490-3700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIBAAA

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1720204936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN ROAD",
            "address_2": "SUITE 101",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036890",
            "telephone_number": "703-573-0800",
            "fax_number": "703-573-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 WOODBURN ROAD",
            "address_2": "SUITE 101",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220036890",
            "telephone_number": "703-573-0800",
            "fax_number": "703-573-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC AND VASCULAR CARE OF VIRGINIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-573-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101052912",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.