NPIMap

Organization Active NPI

Neighborhood Health

Doing business as Neighborhood Health at Arlington CSB

  • Federally Qualified Health Center (FQHC)
  • Arlington, VA
National Provider Identifier
1790001741
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH
Doing business as
Neighborhood Health at Arlington CSB
Practice address
2100 Washington Blvd Ste 294
Arlington, VA 22204-5703
Phone
(703) 535-5568
Fax
(703) 299-1794
NPI assigned
Apr 15, 2010
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Basim Khan, M.D.NPI 1477880045
Title
Interim Executive Director
Phone
(703) 535-5568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2100 Washington Blvd Ste 294
Arlington, VA 22204-5703

Mailing address

PO Box 2518
Alexandria, VA 22301-0518
Phone (703) 535-5538

Other names 1

  • Neighborhood Health at Arlington CSB Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040707000325 DC Part B Supplier - Clinic/Group Practice 7517853419 Receives reassigned benefits from 100 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Annandale, VA; Alexandria, VA
O20160414000861 VA Part A Provider - Federally Qualified Health Center (FQHC) 7517853419 Practice locations: Arlington, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790001741. Details of each certification follow.

Federally qualified health center certification: CCN 491946

Legal name
NEIGHBORHOOD HEALTH
Doing business as
NEIGHBORHOOD HEALTH AT ARLINGTON CSB
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 22, 2016
Last certification
Feb 22, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 7, 1997 in VA
Enrollment address
2100 Washington Blvd
Arlington, VA 22204-5703

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Locations

2100 Washington Blvd
Ste 294
Arlington, VA 22204

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alisa Whyte Individual Corporate DirectorBoard Vice President Aug 21, 2017
Miriam Aguila Individual Corporate DirectorBoard Member Oct 5, 2015
Nora Partlow Individual Corporate DirectorBoard Member Dec 16, 2019
Basim N Khan Individual Corporate DirectorCeo Sep 17, 2014
W-2 Managing EmployeeCeo Sep 17, 2014
Lisa Chimento Individual Corporate DirectorTreasurer/Secretary Sep 20, 2020
Michael Millman Individual Corporate DirectorBoard President Mar 30, 2015
Muhammad Arif Individual Corporate DirectorBoard Member Dec 17, 2018
Lolita Youmans Individual Corporate DirectorBoard Member Dec 20, 2021
Elhafedh Talebimijine Individual Corporate DirectorBoard Member Mar 18, 2019
Paola Navarro Individual Corporate DirectorBoard Member Oct 5, 2015

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1790001741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2518",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223010518",
            "telephone_number": "703-535-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WASHINGTON BLVD STE 294",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222045703",
            "telephone_number": "703-535-5568",
            "fax_number": "703-299-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "BASIM",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-535-5568",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood Health at Arlington CSB",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neighborhood Health at Arlington CSB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.