Organization Active NPI

Abdul Wahab M D P C

  • Nephrology Physician
  • Falls Church, VA
National Provider Identifier
1902178726
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0101048306 Issued in VA
Legal business name
ABDUL WAHAB M D P C
Practice address
6400 Arlington Blvd
940
Falls Church, VA 22042-2325
Phone
(703) 241-1010
Fax
(703) 241-7723
NPI assigned
Feb 9, 2012
Last updated
Feb 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Authorized official

Name
Dr. Abdul Wahab, MDNPI 1043230980
Title
Physician
Phone
(703) 241-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0101048306 VA Primary

Addresses

Primary practice location

6400 Arlington Blvd
940
Falls Church, VA 22042-2325

Mailing address

6400 Arlington Blvd
940
Falls Church, VA 22042-2325
Phone (703) 241-1010

Other identifiers 1

IdentifierTypeStateIssuer
5604451MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120208000171 DC Part B Supplier - Clinic/Group Practice 0749447415 Receives reassigned benefits from 1 practitioner
Practice locations: Falls Church, VA; Springfield, VA

National Provider Directory

National Provider Directory

Locations

6365 Rolling Mill Pl
Ste 103
Springfield, VA 22152
Phone (703) 569-6686

Practitioners & affiliated clinicians

Practitioners 2

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": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1902178726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 ARLINGTON BLVD",
            "address_2": "940",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422325",
            "telephone_number": "703-241-1010",
            "fax_number": "703-241-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 ARLINGTON BLVD",
            "address_2": "940",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220422325",
            "telephone_number": "703-241-1010",
            "fax_number": "703-241-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABDUL WAHAB M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "WAHAB",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-241-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101048306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5604451",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.