NPIMap

Individual provider Active NPI

Myong Ho Nam, MD

  • Blood Banking & Transfusion Medicine Physician
  • Falls Church, VA
National Provider Identifier
1770584476
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X
License
0101040202 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-6679
NPI assigned
Aug 3, 2005
Last updated
Mar 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 0101040202 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

PO Box 221322
Chantilly, VA 20153-1322
Phone (703) 691-2516

Other identifiers 1

IdentifierTypeStateIssuer
1770584476MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040520000488 DC Practitioner - Pathology 1456342211 Reassigns benefits to 1 organization
I20141022002462 VA Practitioner - Pathology 1456342211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care Services - PathologyGroup PAC ID 8426241647, 46 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

3023 Hamaker CT
Suite 400
Fairfax, VA 22031-2247
Phone (571) 226-8380

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfax Pathology Associates LTD Past Accepting new patients
Fairfax Pathology Associates, LTD. Past Accepting new patients
Pathstar, P.C. Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1770584476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221322",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201531322",
            "telephone_number": "703-691-2516",
            "fax_number": "703-691-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "MYONG",
        "middle_name": "HO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "VA",
            "license": "0101040202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770584476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.