Squadron Health Enterprises, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SQUADRON HEALTH ENTERPRISES, LLC

Practice address

10602 Allenwood LN
Great Falls, VA 22066-3229

Phone

(202) 262-0748

NPI assigned

Apr 3, 2020

Organization subpart

No

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

Authorized official

Name

Sarah J Donovan

Title

Ceo

Phone

(202) 746-6136

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1720617525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 SUNSET HILLS RD UNIT 8124",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201958091",
            "telephone_number": "202-746-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10602 ALLENWOOD LN",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220663229",
            "telephone_number": "202-262-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUADRON HEALTH ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "DONOVAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-746-6136"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Great Falls, VA
• Providers in Great Falls, VA by specialty
• General Practice Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.