Active NPI
Elaine Wolf Komarow, L. AC.
- Acupuncturist
- Annandale, VA
National Provider Identifier
1760637623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 0121-000004
- Practice address
- 5021D Backlick Rd
Annandale, VA 22003-6043 - Phone
- (703) 642-8404
- NPI assigned
- Nov 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 0121-000004 | VA | Primary |
Addresses
Primary practice location
5021D Backlick Rd
Annandale, VA 22003-6043
Mailing address
5021D Backlick Rd
Annandale, VA 22003-6043
Phone (703) 642-8404
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0121-000004 | VA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227052800000",
"number": "1760637623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5021D BACKLICK RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220036043",
"telephone_number": "703-642-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5021D BACKLICK RD",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220036043",
"telephone_number": "703-642-8404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMAROW",
"first_name": "ELAINE",
"middle_name": "WOLF",
"name_prefix": "Ms.",
"credential": "L. AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-19",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "VA",
"license": "0121-000004",
"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 Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.