Annandale Medical Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101049525 Issued in VA

Legal business name

ANNANDALE MEDICAL ASSOCIATES PC

Practice address

4229 Lafayette Center Drive
Suite #1790
Chantilly, VA 20151-1267

Phone

(703) 378-3508

Fax

(703) 378-6414

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Ingrid Insook Chung, M.D.NPI 1073622742

Title

MD

Phone

(703) 378-3508

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ingrid Insook Chung, MD

  • Internal Medicine Physician
  • Chantilly, VA
  • NPI 1073622742

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1861616310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9302",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221020302",
            "telephone_number": "703-378-3508",
            "fax_number": "703-378-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 LAFAYETTE CENTER DRIVE",
            "address_2": "SUITE #1790",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511267",
            "telephone_number": "703-378-3508",
            "fax_number": "703-378-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNANDALE MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "INSOOK",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "703-378-3508",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101049525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLANCE PPO/MAMSI",
            "identifier": "3100539",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-ANTHEM",
            "identifier": "463068",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-CAREFIRST",
            "identifier": "38080001",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "461868",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "136631",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4528765",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia P Angel, PA-C
• Anh H Pham DDS & Barry R Maharaj DDS PC (Chantilly Oral Surgery)
• Mathilde Sarah Lisa Anik Vedel
• Swapnika Ankana, D.P.T.
• Vidya K Annamreddy
• Nymisha Anne
• Fiona L Apple, L.P.C.
• Briana Gisselle Argueta Medrano
• Nneka Ariguzo
• Mina Armanious, DDS

• Internal Medicine Physician in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.