NPIMap

Organization Active NPI

Fairfax Neonatal Associates, LLC

  • Neonatal-Perinatal Medicine Physician
  • Fairfax, VA
National Provider Identifier
1821055609
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
FAIRFAX NEONATAL ASSOCIATES, LLC
Practice address
3060 Williams Drive
Suite 520
Fairfax, VA 22031-4648
Phone
(703) 289-1400
Fax
(703) 289-1414
NPI assigned
Apr 27, 2006
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Mr. Gregory Edward Bengston
Title
Evp, Coo
Phone
(703) 289-1422

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080N0001X Primary
Pediatric Pulmonology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0214X

Addresses

Primary practice location

3060 Williams Drive
Suite 520
Fairfax, VA 22031-4648

Mailing address

3060 Williams Drive
Suite 520
Fairfax, VA 22031-4648
Phone (703) 289-1400

Other names 1

  • Fairfax Neonatal Associates Other name

National Provider Directory

National Provider Directory
Tax ID family
Janet K Hilliard DO6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3060 Williams Dr
Ste 520
Fairfax, VA 22031
Phone (703) 776-3547

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1821055609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 WILLIAMS DRIVE",
            "address_2": "SUITE 520",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314648",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 WILLIAMS DRIVE",
            "address_2": "SUITE 520",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314648",
            "telephone_number": "703-289-1400",
            "fax_number": "703-289-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX NEONATAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "BENGSTON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "EVP, COO",
        "authorized_official_telephone_number": "703-289-1422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairfax Neonatal Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.