DULLES PAIN & FUNCTIONAL MEDICINE (NPI# 1518573534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518573534 |
| Entity Type | Organization |
| Organization Name | DULLES PAIN & FUNCTIONAL MEDICINE |
| Practice Address |
20 Pidgeon Hill Dr Ste 205 Sterling VA 20165-6134 |
| Mailing Address |
Po Box 2521 Reston VA 20195-0521 |
| Practice Telephone | 7038848400 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-10-14 |
| Authorized Official Name | ISSAM KHAYATA (OWNER) |
| Authorized Official Telephone | 7038848400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207LC0200X |
Anesthesiology Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1958 Opitz Blvd, Woodbridge, VA 221913304 | 7034941111 |
| Street Address |
20 PIDGEON HILL DR STE 205 |
| City | STERLING |
| State | VA |
| Zip Code | 20165-6134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578042073 | Potomac Speech, LLC | Clinic/Center | 20657 Shoal Place, Sterling, VA 20165 | 2018-08-07 |
| 1386138600 | Jennifer M Bennett | Specialist | 46691 Cavendish Sq, Sterling, VA 20165 | 2018-06-20 |
| 1689163271 | Horizon Healthcare Professionals, LLC | Registered Nurse | 6 Pidgeon Hill Dr Ste 309, Sterling, VA 20165 | 2018-05-09 |
| 1336668573 | Jennifer Beatriz Henriquez | Student in an Organized Health Care Education/Training Program | 88 Bickel Ct, Sterling, VA 20165 | 2017-09-19 |
| 1134648413 | Alannah Angels Care, LLC | Home Health | 47672 Comer Sq, Sterling, VA 20165 | 2017-09-18 |
| 1215472709 | Hiba Aljumaah | Non-emergency Medical Transport (VAN) | 20829 Miranda Falls Sq, Sterling, VA 20165 | 2016-12-20 |
| 1629465299 | The Key Center of Florida | Health Maintenance Organization | 21155 Whitfield Pl 206, Sterling, VA 20165 | 2015-04-22 |
| 1740679265 | Shahla Zamani | Pharmacist | 46380 Monocacy Square, Potomac Falls, VA 20165 | 2015-01-21 |
| 1598006785 | Jeanine Marie Burke | Physical Therapist | 2 Pidgeon Hill Dr Ste 350, Sterling, VA 20165 | 2013-03-13 |
| 1134464126 | Faisal Hasan | Specialist | 46770 Willowood Place, Potomac Falls, VA 20165 | 2012-12-03 |
| Find all providers in zip 20165 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629011895 | Loudoun Anesthesia/loudoun Interventional Pain Center | Anesthesiology | 46161 Westlake Dr, Sterling, VA 20165-5871 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568821221 | Virginia Innovative Pain and Spine | Anesthesiology | 2532 Mill Rd, Powhatan, VA 23139-5203 | 2016-02-23 |
| 1285919472 | Pca Pain Care Center of Virigina, Inc | Anesthesiology | 825 Davis St # E, Blacksburg, VA 24060-7013 | 2011-10-19 |
| 1659667327 | Parviz Navidi | Anesthesiology | 899 Chinquapin Rd, Mc Lean, VA 22102-1039 | 2011-06-21 |
| 1013165331 | Cody Rowan | Anesthesiology | 575 Ray C Hunt Dr, Charlottesville, VA 22903 | 2008-08-28 |
| 1619149648 | Professional Anesthesia Group, LLC | Anesthesiology | 1500 Dixon St Ste 101, Fredericksburg, VA 22401-7231 | 2008-03-31 |
| 1881875920 | Memorial Anesthesia, LLC | Anesthesiology | 8262 Atlee Rd., Mob 3 #100, Mechanicsville, VA 23116 | 2007-11-16 |
| 1073708566 | Joseph Kevin Statkus | Anesthesiology | 106 Keswick Ct, Winchester, VA 22602-7807 | 2007-09-08 |
| 1043403504 | Nova Pain Clinic Inc | Anesthesiology | 6151 Fuller Ct, Alexandria, VA 22310-2541 | 2007-08-19 |
| 1144340514 | John C. Rowlingson | Anesthesiology | 2nd Hospital Dr, Charlottesville, VA 22908-0001 | 2007-03-30 |
| 1356469522 | Chheany Walter Ung | Anesthesiology | 3800 Electric Rd, Suite 307, Roanoke, VA 24018-4569 | 2007-03-27 |
| Find all providers with the same taxonomy | ||||
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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.