NPIMap

Organization Active NPI

Inova Health System Services

  • Skilled Nursing Facility
  • Fairfax, VA
National Provider Identifier
1912032012
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2594 Issued in VA
Legal business name
INOVA HEALTH SYSTEM SERVICES
Practice address
4315 Chain Bridge Rd
Fairfax, VA 22030-3061
Phone
(703) 934-5000
Fax
(703) 934-5092
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Robert Hager
Title
Senior Adminstrator
Phone
(703) 279-4252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2594 VA Primary

Addresses

Primary practice location

4315 Chain Bridge Rd
Fairfax, VA 22030-3061

Mailing address

2990 Telestar CT
Suite 3LT
Falls Church, VA 22042-1207
Phone (571) 423-5747

Other identifiers 2

IdentifierTypeStateIssuer
004951743MedicaidVA
004960131MedicaidVA

Other names 1

  • COMMONWEALTH CARE CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2990 Telestar Ct
Ste 3LT
Falls Church, VA 22042

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1912032012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 TELESTAR CT",
            "address_2": "SUITE 3LT",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421207",
            "telephone_number": "571-423-5747",
            "fax_number": "571-423-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 CHAIN BRIDGE RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303061",
            "telephone_number": "703-934-5000",
            "fax_number": "703-934-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INOVA HEALTH SYSTEM SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "HAGER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SENIOR ADMINSTRATOR",
        "authorized_official_telephone_number": "703-279-4252"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004951743",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004960131",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMONWEALTH CARE CENTER",
            "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 Nov 18, 2010; 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.