CHANTILLY SPECIALISTS, LTD. OF VIRGINIA (NPI# 1376853341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376853341 |
| Entity Type | Organization |
| Organization Name | CHANTILLY SPECIALISTS, LTD. OF VIRGINIA |
| Practice Address |
14121 Parke Long Ct Suite 112 Chantilly VA 20151-1647 |
| Practice Telephone | 5712515471 |
| Practice Fax Number | 7033784909 |
| Mailing Telephone | 5712515471 |
| Mailing Fax Number | 7033784909 |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |
| Authorized Official Name | MR. PAUL P BOCCONE (PRESIDENT) |
| Authorized Official Telephone | 5712515471 |
| Authorized Official Credential | J.D., LL.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 49D2006729 | VA | Laboratories |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497079073 | Chantilly Specialists, Ltd. of Virginia | Family Medicine | 4200 Lafayette Center Dr, Ste R, Chantilly, VA 20151-1241 | 2010-03-25 |
| Street Address |
14121 PARKE LONG CT SUITE 112 |
| City | CHANTILLY |
| State | VA |
| Zip Code | 20151-1647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154389393 | Donna G Warner | Registered Nurse | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2006-05-03 |
| 1245745967 | Angela S Goodson-acevedo | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-12-04 |
| 1164936357 | Joanne Aurelien | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-11-27 |
| 1215448428 | Sereta Cohen | Family Medicine | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-10-14 |
| 1780194357 | Tamara Watlington Avery | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-10-09 |
| 1255841391 | Cynthia Lorraine Orner | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-10-03 |
| 1417466376 | Cynthia U. Adighibe | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-09-22 |
| 1851800700 | Colleen Marie Rule | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-09-22 |
| 1790202927 | Uchenna A Murphy | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-08-28 |
| 1942725460 | Brittney Walls | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-08-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023635695 | Sabah Home Care | Home Health | 4221 Walney Rd Suite 500 C, Chantilly, VA 20151 | 2020-06-30 |
| 1205485976 | Huang Wellness Center LLC | Acupuncturist | 14145 Robet Paris Ct, Chantilly, VA 20151 | 2019-09-05 |
| 1376032714 | Myeyedr Optometry of Virginia, Pllc | Optometrist | 14337 Newbrook Drive, Suite 400, Chantilly, VA 20151 | 2018-05-01 |
| 1013405950 | Chantilly Modern Dentistry, PC | Dentist | 14337 Newbrook Dr., Suite 200, Chantilly, VA 20151 | 2018-04-26 |
| 1972090389 | Wegmans Food Markets, Inc. | Pharmacy | 14361 Newbrook Dr., Chantilly, VA 20151 | 2018-04-20 |
| 1922526714 | Cynthia Anne Biggar | Specialist/Technologist | 13613 Bare Island Drive, Chantilly, VA 20151 | 2017-09-01 |
| 1497297717 | Rebekah Lee Hinders | Nurse Practitioner | 3914 Centrevill Rd, Suite 101, Chantilly, VA 20151 | 2016-11-17 |
| 1043761117 | Victoria Ranti Balogun | Nurse Practitioner | 14121 Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-10-24 |
| 1619424694 | Erin Booker | Nurse Practitioner | Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-09-07 |
| 1326419078 | Amparo Emilia Kidd | Nurse Practitioner | 14121 Parke Long Court, Suite 201, Chantilly, VA 20151 | 2015-10-07 |
| Find all providers in zip 20151 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205445491 | Fairfax Medical Lab LLC | Clinical Medical Laboratory | 4221 Walney Rd Ste 401a, Chantilly, VA 20151-2987 | 2020-07-24 |
| 1659900348 | Microgen Health, Inc | Clinical Medical Laboratory | 14225 Sullyfield Cir Ste E, Chantilly, VA 20151-1688 | 2020-04-03 |
| 1780128744 | Jie Xu | Clinical Medical Laboratory | 13729 Autumn Vale Ct, Chantilly, VA 20151-3544 | 2016-12-10 |
| 1104852573 | Fairfax Medical Laboratories, Inc. | Clinical Medical Laboratory | 4200 Pleasant Valley Rd, Chantilly, VA 20151-1211 | 2006-06-25 |
| 1316442668 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 14225 Newbrook Drive, 1st Floor, Suite A, Chantilly, VA 20151 | 2018-03-28 |
| 1265774095 | Quest Diagnostics | Clinical Medical Laboratory | 14225 Newbrook Dr, Department of Anatomic Pathology, Chantilly, VA 20151-2228 | 2013-03-19 |
| 1841351566 | Jeffrey Samuel Dlott | Clinical Medical Laboratory | 14225 Newbrook Dr, Chantilly, VA 20151-2228 | 2006-12-13 |
| 1447296272 | Quest Diagnostics Nichols Institute, Inc. | Clinical Medical Laboratory | 14225 Newbrook Dr, Chantilly, VA 20151-2228 | 2006-06-21 |
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|---|---|---|---|---|
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| 1942809934 | Labmd2, Inc | Clinical Medical Laboratory | 20804 Edds Ln, Potomac Falls, VA 20165-7904 | 2020-10-21 |
| 1366040917 | Ikare Renal Solutions LLC | Clinical Medical Laboratory | 8534 Ashington Way, Williamsburg, VA 23188-6647 | 2020-10-15 |
| 1649878364 | Iqgenetix LLC | Clinical Medical Laboratory | 11100 Endeavor Ct Ste 137, Manassas, VA 20109-4027 | 2020-10-14 |
| 1437756525 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 109 Bridge St Ste 101, Danville, VA 24541-1222 | 2020-10-02 |
| 1750923520 | Metropolitan Laboratory Services Inc | Clinical Medical Laboratory | 12011 Lee Jackson Memorial Hwy Ste 200, Fairfax, VA 22033-3310 | 2019-10-14 |
| 1346881067 | Zenith Diagnostics, Inc. | Clinical Medical Laboratory | 13042 Rivers Bend Road, Chester, VA 23836-2383 | 2019-10-03 |
| 1952962482 | Accurate Medical Lab Inc | Clinical Medical Laboratory | 3927 Old Lee Hwy Ste 102d, Fairfax, VA 22030-2422 | 2019-06-25 |
| 1447711163 | Solstas Lab Partners Group LLC | Clinical Medical Laboratory | 204 E Washington St Ste C, Lexington, VA 24450-2718 | 2019-03-26 |
| 1851851893 | Solstas Lab Partners Group LLC | Clinical Medical Laboratory | 3239 Electric Rd Ste A, Roanoke, VA 24018-6444 | 2019-03-25 |
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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.