Inova Reston MRI Center LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

INOVA RESTON MRI CENTER LLC

Doing business as

The Fairfax MRI Center at Reston

Practice address

100 Elden St Ste 16M
Herndon, VA 20170-4873

Phone

(703) 481-9400

Fax

(703) 481-9408

NPI assigned

Oct 15, 2009

Last updated

Nov 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alice Pope

Title

Chief Financial Officer

Phone

(703) 289-2048

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• THE FAIRFAX MRI CENTER AT RESTON Doing business as

Tax ID family

Inova Reston MRI Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Inova Reston MRI Center LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Centreville, VA
  • NPI 1417674821
  NPD tax ID
• Inova Reston MRI Center LLC

  dba Fairfax MRI and Imaging Center at Tysons

  • Radiology Clinic/Center
  • Falls Church, VA
  • NPI 1619265766
  NPD tax ID
• Inova Reston MRI Center LLC

  dba Fairfax Pet CT Imaging Center

  • Radiology Clinic/Center
  • Fairfax, VA
  • NPI 1952636581
  NPD tax ID
• Inova Reston MRI Center LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Herndon, VA
  • NPI 1972838993
  NPD tax ID

Locations

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1750616397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 MERRILEE DR",
            "address_2": "STE 230",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314420",
            "telephone_number": "703-788-8477",
            "fax_number": "703-698-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELDEN ST STE 16M",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704873",
            "telephone_number": "703-481-9400",
            "fax_number": "703-481-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INOVA RESTON MRI CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "703-289-2048"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3120417",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "9616343",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972838993",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017668",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "6123294",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE FAIRFAX MRI CENTER AT RESTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE FAIRFAX MRI CENTER AT RESTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zarmina Ifzal, DMD
• Shamim Akhtar Imam, M.D.
• Imran Akram MD PC
• William A Incatasciato, MD
• Eric Aaron Ingold, DPT
• Inova Reston MRI Center LLC
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• Magnetic Resonance Imaging (MRI) Clinic/Center in Herndon, VA
• Providers in Herndon, VA by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.