Rediclinic of VA, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF VA, LLC

Practice address

2260A Hunters Woods PLZ
Reston, VA 20191-2898

Phone

(713) 358-4881

Fax

(713) 358-4881

NPI assigned

Dec 15, 2015

Organization subpart

Yes

Parent organization

REDICLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Danielle Barrera

Title

Chief Operating Officer

Phone

(713) 580-9489

Specialties & licenses 1

Addresses

Part of

Rediclinic LLC

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1790140903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLZ",
            "address_2": "SUITE 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "713-335-1731",
            "fax_number": "713-574-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260A HUNTERS WOODS PLZ",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201912898",
            "telephone_number": "713-358-4881",
            "fax_number": "713-358-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC OF VA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REDICLINIC, LLC",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "713-580-9489"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Rausa, D.O
• Kathleen A Rausch, M.D.
• Rosemarie Ann Raymond, APRN-BC NP
• Jamal Raza, M.D.
• Babak Razmazma, DDS
• Mehrin Redjaeian, LPN
• Nina Marie Redlin
• Alexander Bramwell Reed, MD
• James D Reeves, M.D.
• Regenerative Medicine Center, PLC

• Clinic/Center in Reston, VA
• Providers in Reston, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.