DR. MARC A CHILDRESS (NPI# 1124117015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124117015 |
| Entity Type | Individual |
| Full Name | DR. MARC A CHILDRESS |
| Credential | M.D. |
| Practice Address |
3650 Joseph Siewick Drive Suite 400 Fairfax VA 22033 |
| Mailing Address |
12011 Lee Jackson Memorial Highway Suite 504 Fairfax VA 22033-3315 |
| Practice Telephone | 7033912020 |
| Practice Fax Number | 7033911211 |
| Mailing Telephone | 7033912070 |
| Mailing Fax Number | 7032733943 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101252825 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01059898A | IN | Allopathic & Osteopathic Physicians |
| Street Address |
3650 JOSEPH SIEWICK DRIVE SUITE 400 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316925340 | Francis G O'connor | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax Family Practice Centers, P.C., Fairfax, VA 22033-1715 | 2006-01-09 |
| 1659865970 | Elizabeth Flory | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2018-06-20 |
| 1518349638 | Shetal Rameshchandra Patel | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2015-06-25 |
| 1154522951 | Daniel Bowman Shepherd Banigan | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2007-05-30 |
| 1396946109 | Kathryn Wilson Hare | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2007-05-30 |
| 1639296254 | Fairfax Family Practice Centers PC | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2007-03-26 |
| 1609882752 | Amanda Gia Tran | Physician Assistant | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2006-07-31 |
| 1558328534 | Garry W Ho | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2006-04-26 |
| 1750352738 | Amy Y Nobu | Family Medicine | 3650 Joseph Siewick Drive, Suite 400, Fairfax, VA 22033 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922561943 | Tammy Jones Md Pllc | Family Medicine | 9683 Main St Ste A, Fairfax, VA 22031-3755 | 2019-04-08 |
| 1194209544 | Aramcare, LLC | Family Medicine | 11230 Waples Mill Rd Ste 125, Fairfax, VA 22030-6002 | 2018-09-21 |
| 1881112902 | Cheryl Anne Arenella | Family Medicine | 11150 Fairfax Blvd Ste 200, Fairfax, VA 22030-5066 | 2017-09-08 |
| 1720448442 | Integrated Wellness Md, LLC | Family Medicine | 8316 Arlington Blvd Ste 206, Fairfax, VA 22031-5216 | 2016-02-24 |
| 1255710554 | Kristin Adelle Harrington | Family Medicine | 10530 Rosehaven St Ste 100, Fairfax, VA 22030-2888 | 2015-05-20 |
| 1194111641 | Stephanie Singh | Family Medicine | 3998 Fair Ridge Dr Ste 125, Fairfax, VA 22033-2908 | 2015-04-11 |
| 1811208028 | Hanna Yoon | Family Medicine | 3650 Joseph Siewick Dr Ste 400, Fairfax, VA 22033-1715 | 2010-06-23 |
| 1285879981 | Sabeen Pervaiz | Family Medicine | 4041 University Dr Ste 405, Fairfax, VA 22030-3410 | 2008-12-09 |
| 1164685103 | Carolyn E. Snarskis | Family Medicine | 3650 Joseph Siewick Dr., Suite 400, Fairfax, VA 22033 | 2008-07-09 |
| 1952583650 | Phyllis Jean Drew | Family Medicine | 9683-a Main Street, Fairfax, VA 22031-3755 | 2007-12-04 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.