Chantilly Foot & Ankle Center, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0103300742 Issued in VA

Legal business name

CHANTILLY FOOT & ANKLE CENTER, LLC

Practice address

4080 Lafayette Center Dr
Suite 170
Chantilly, VA 20151-1247

Phone

(703) 490-5599

Fax

(703) 766-5047

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Farshad Bathaee, DPM

Title

Owner

Phone

(703) 490-5599

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811079965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220734",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201530734",
            "telephone_number": "703-490-5599",
            "fax_number": "703-766-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 LAFAYETTE CENTER DR",
            "address_2": "SUITE 170",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511247",
            "telephone_number": "703-490-5599",
            "fax_number": "703-766-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTILLY FOOT & ANKLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BATHAEE",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-490-5599",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103300742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Foot & Ankle Surgery Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.