Annandale Gerontology Clinic

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

0101252858 Issued in VA

Legal business name

ANNANDALE GERONTOLOGY CLINIC

Practice address

4216 Evergreen LN Ste 121
Annandale, VA 22003

Phone

(301) 893-4124

Fax

(703) 662-6165

NPI assigned

Oct 2, 2017

Organization subpart

No

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

Authorized official

Name

Jiho Choi, MDNPI 1225149859

Title

Owner/Staff Physician

Phone

(301) 893-4124

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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.

• Jiho Choi, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Annandale, VA
  • NPI 1225149859

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1932619210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 EVERGREEN LN STE 121",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033256",
            "telephone_number": "301-893-4124",
            "fax_number": "703-662-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 EVERGREEN LN STE 121",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "22003",
            "telephone_number": "301-893-4124",
            "fax_number": "703-662-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNANDALE GERONTOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JIHO",
        "authorized_official_title_or_position": "OWNER/STAFF PHYSICIAN",
        "authorized_official_telephone_number": "301-893-4124",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "VA",
            "license": "0101252858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Anderson, LCSW
• Fern Andraos, M.ED., CCC-SLP
• Genitra Andrews-Hypolite, PT,MPT
• Nina Franco Angeles, LPC, NCC
• Annandale Family Medicine, P.C.
• Annandale OB GYN
• Annandale Pediatric Assoc Inc
• Annandale Spine Physicians, Inc.
• Annandale VA Opco LLC
• Annapath of Virginia Inc.

• Geriatric Medicine (Family Medicine) Physician in Annandale, VA
• Providers in Annandale, VA by specialty
• Geriatric Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.