ASSOCIATED FOOT & ANKLE CENTERS OF NORTHERN VIRGINIA PC (NPI# 1376795765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376795765 |
| Entity Type | Organization |
| Organization Name | ASSOCIATED FOOT & ANKLE CENTERS OF NORTHERN VIRGINIA PC |
| Other Organization Name | LAKERIDGE FOOT & ANKLE CENTER |
| Practice Address |
10730 Main St Fairfax VA 22030-3704 |
| Mailing Address |
1721 Financial Loop Lake Ridge VA 22192-2460 |
| Practice Telephone | 7036910670 |
| Practice Fax Number | 7033852865 |
| Mailing Telephone | 7034919500 |
| Mailing Fax Number | 7034919994 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2013-12-30 |
| Authorized Official Name | DR. DOUGLAS E STABILE (PRESIDENT) |
| Authorized Official Telephone | 7034919500 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0103000774 | VA | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| LAKERIDGE FOOT & ANKLE CENTER | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467533471 | Associated Foot & Ankle Centers of Northern Virginia PC | Podiatrist | 1721 Financial Loop, Woodbridge, VA 22192-2460 | 2006-10-17 |
| Street Address |
10730 MAIN ST |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-3704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477516979 | Fairfax Surgical Center, L.p. | Clinic/Center | 10730 Main St, Fairfax, VA 22030-3704 | 2006-04-07 |
| 1326268350 | Anne Price Pilcher | Nurse Anesthetist, Certified Registered | 10730 Main St, Fairfax, VA 22030-3704 | 2007-05-01 |
| 1689721805 | Edith C Hunter | Nurse Anesthetist, Certified Registered | 10730 Main St, Fairfax, VA 22030-3704 | 2007-01-03 |
| 1871532077 | Sheila Kathleen Cooke | Nurse Anesthetist, Certified Registered | 10730 Main St, Fairfax Surgical Center, Fairfax, VA 22030 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710369293 | Samuel Tischler | Podiatrist | 3302 Lothian Rd, Fairfax, VA 22031-4842 | 2015-06-22 |
| 1598712150 | My Hoa Kaas Dpm PC | Podiatrist | 2826 Old Lee Highway #220, Fairfax, VA 22031-4323 | 2006-05-28 |
| 1174516819 | Richard Scott Mendelsohn | Podiatrist | 9918 Main St, Fairfax, VA 22031-3901 | 2005-08-29 |
| 1174940449 | Jugal Dharia | Podiatrist | 10721 Main St Ste 3500, Fairfax, VA 22030-6909 | 2014-03-25 |
| 1255628350 | Corine Leigh Creech | Podiatrist | 8501 Arlington Blvd Ste 200, Fairfax, VA 22031-4625 | 2011-07-09 |
| 1649573205 | Jay Daniel Ryan | Podiatrist | 2826 Old Lee Hwy, Suite 220, Fairfax, VA 22031-4323 | 2010-12-20 |
| 1548575780 | Apna Podiatry | Podiatrist | 3650 Joseph Siewick Dr, Suite 200, Fairfax, VA 22033-1710 | 2010-08-12 |
| 1073831780 | Fair Oaks Podiatry and Sports | Podiatrist | 3620 Joseph Siewick Dr, 303, Fairfax, VA 22033-1756 | 2010-05-06 |
| 1912140310 | Fair Oaks Podiatry and Sports | Podiatrist | 3620 Joseph Siewick Dr, Suite 303, Fairfax, VA 22033-1756 | 2009-04-14 |
| 1073655643 | Rostana Said | Podiatrist | 10721 Main St, Suite 103, Fairfax, VA 22030-6914 | 2007-02-12 |
| 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.