Individual provider Active NPI

Edward Kenneth Jeffer, M.D.

  • Psychiatry Physician
  • Falls Church, VA
National Provider Identifier
1902829484
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101053378 Issued in VA
Practice address
3701 S George Mason Dr
415N
Falls Church, VA 22041-3758
Phone
(703) 578-1068
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101053378 VA Primary
Psychiatry Physician 2084P0800X 8504 NV
Psychiatry Physician 2084P0800X 14706 MS
Psychiatry Physician 2084P0800X 9900263 NC
Psychiatry Physician 2084P0800X 20744 SC
Psychiatry Physician 2084P0800X 00019515 AL
Psychiatry Physician 2084P0800X 041143 GA
Psychiatry Physician 2084P0800X G13625 CA
Psychiatry Physician 2084P0800X MD0000027749 TN
Psychiatry Physician 2084P0800X MD.11555R LA

Addresses

Primary practice location

3701 S George Mason Dr
415N
Falls Church, VA 22041-3758

Mailing address

3701 S George Mason Dr
415N
Falls Church, VA 22041-3758
Phone (703) 578-1068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00019515ALMDPsychiatry Physician
G13625CAMDPsychiatry Physician
041143GAMDPsychiatry Physician
MD.11555RLAMDPsychiatry Physician
14706MSMDPsychiatry Physician
9900263NCMDPsychiatry Physician
8504NVMDPsychiatry Physician
20744SCMDPsychiatry Physician
MD0000027749TNMDPsychiatry Physician
0101053378VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Mental Health Management LLC Psychiatry Past Accepting new patients
Bay Psychiatric Associates Psychiatry PastSince Oct 16, 2012 Accepting new patients
Maine Behavioral Healthcare Past Accepting new patients
Georgia Department of Human Resources Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902829484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S GEORGE MASON DR",
            "address_2": "415N",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413758",
            "telephone_number": "703-578-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 S GEORGE MASON DR",
            "address_2": "415N",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220413758",
            "telephone_number": "703-578-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFER",
        "first_name": "EDWARD",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101053378",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "8504",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "14706",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9900263",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "20744",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00019515",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "041143",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G13625",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD0000027749",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD.11555R",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.