Nova Portable Xray LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

NOVA PORTABLE XRAY LLC

Practice address

4020 David LN
Alexandria, VA 22311-1111

Phone

(573) 239-6116

NPI assigned

Nov 4, 2022

Organization subpart

No

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

Authorized official

Name

Omar KhasawinahNPI 1841913191

Title

Administrator

Phone

(573) 239-6116

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Portable X-ray supplier certification: CCN 49X0009832

Legal name

NOVA PORTABLE XRAY LLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Jan 3, 2025

Last certification

Jan 3, 2025

Ownership / control type

Corporation

Facility address

4020 David Lane
Alexandria, VA 22311

Practitioners 1

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

• Omar Khasawinah

  • Radiologic Technologist
  • Alexandria, VA
  • NPI 1841913191
  NPD Authorized official

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1891402293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 DAVID LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111111",
            "telephone_number": "573-239-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 DAVID LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111111",
            "telephone_number": "573-239-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA PORTABLE XRAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "KHASAWINAH",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-239-6116"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.