Organization Active NPI

Premise Heath of Connecticut Medical PC

  • Primary Care Clinic/Center
  • Reston, VA
National Provider Identifier
1760625917
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PREMISE HEATH OF CONNECTICUT MEDICAL PC
Practice address
12000 Sunrise Valley Dr BLDG E
Reston, VA 20191-3403
Phone
(615) 468-6548
Fax
(615) 468-0477
NPI assigned
Apr 16, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Corporate family (same tax ID) 20

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

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Connecticut Medical PC (21 organizations share this tax ID)

Locations

32 Chicago Ave
Fl 2
Groton, CT 06340

12524 Sunrise Valley Dr
Bldg E
Reston, VA 20191

12000 Sunrise Valley Dr
Bldg E
Reston, VA 20191
Phone (615) 468-6548

12524 Sunrise Valley Dr
Reston, VA 20191
Phone (703) 592-7111

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

NPPES NPI Registry

Primary practice location

12000 Sunrise Valley Dr BLDG E
Reston, VA 20191-3403

Mailing address

12000 Sunrise Valley Dr BLDG E
Reston, VA 20191-3403
Phone (703) 592-7111

Other names 1

NPPES NPI Registry
  • Sprint On Site Health Center Reston Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2026.

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1760625917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 SUNRISE VALLEY DR BLDG E",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913403",
            "telephone_number": "703-592-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 SUNRISE VALLEY DR BLDG E",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201913403",
            "telephone_number": "615-468-6548",
            "fax_number": "615-468-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEATH OF CONNECTICUT MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sprint On Site Health Center Reston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.