STATE OF THE ART REHAB, INC. (NPI# 1669423372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669423372 |
| Entity Type | Organization |
| Organization Name | STATE OF THE ART REHAB, INC. |
| Practice Address |
11166 Fairfax Blvd Suite 202 Fairfax VA 22030-5017 |
| Practice Telephone | 7033853333 |
| Practice Fax Number | 7033853844 |
| Mailing Telephone | 7033853333 |
| Mailing Fax Number | 7033853844 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2007-10-25 |
| Authorized Official Name | DR. SRINIVASON ROGER PARTHASARATHY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7033853333 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
11166 FAIRFAX BLVD SUITE 202 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-5017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760956163 | Sarah Abdel-wahab | Psychologist | 11166 Fairfax Blvd, Fairfax, VA 22030-5017 | 2019-01-18 |
| 1326432964 | Hyosun Schluge | Nurse Practitioner | 11166 Fairfax Blvd, #105, Fairfax, VA 22030-5017 | 2015-03-20 |
| 1609201037 | Justine Simpson | Psychologist | 11166 Fairfax Blvd, Suite 207, Fairfax, VA 22030-5017 | 2013-09-04 |
| 1669714903 | Bridges Therapy and Wellness Center, LLC | Psychologist | 11166 Fairfax Blvd, Suite 207, Fairfax, VA 22030-5017 | 2013-03-25 |
| 1306109590 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 11166 Fairfax Blvd, Suite 105, Fairfax, VA 22030-5017 | 2012-06-21 |
| 1336375450 | Su Min Ko | Physical Medicine & Rehabilitation | 11166 Fairfax Blvd, Suite 105, Fairfax, VA 22030-5017 | 2009-06-03 |
| 1598985434 | Jung Gook Lim | Psychiatry & Neurology | 11166 Fairfax Blvd, Suite 105, Fairfax, VA 22030-5025 | 2007-04-25 |
| 1871657080 | Martha M Gillis | Psychologist | 11166 Fairfax Blvd, Suite 203, Fairfax, VA 22030-5017 | 2006-12-21 |
| 1730277963 | Kalpana Shriprakash Trivedi | Dentist | 11166 Fairfax Blvd, #400, Fairfax, VA 22030-5017 | 2006-10-11 |
| 1831108125 | Anita Zappone | Clinical Nurse Specialist | 11166 Fairfax Blvd, 405, Fairfax, VA 22030-5017 | 2006-08-05 |
| Find all providers in the same location | ||||
| 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 | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306109590 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 11166 Fairfax Blvd, Suite 105, Fairfax, VA 22030-5017 | 2012-06-21 |
| 1013948462 | Michael Sung Chung | Physical Medicine & Rehabilitation | 2826 Old Lee Hwy, Suite 200, Fairfax, VA 22031-4323 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113757 | Vann-virginia Center for Orthopaedics PC | Physical Medicine & Rehabilitation | 6160 Kempsville Cir Ste 110a, Norfolk, VA 23502-3933 | 2020-01-07 |
| 1902220403 | Triumph Medical Advancments | Physical Medicine & Rehabilitation | 43704 Lees Mill Sq, Leesburg, VA 20176-3821 | 2014-02-05 |
| 1659792323 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 7535 Little River Tpke Ste 100c, Annandale, VA 22003-2976 | 2013-12-26 |
| 1174843064 | Bruce Ira Tetalman | Physical Medicine & Rehabilitation | 716 Thimble Shoals Blvd, Suite A, Newport News, VA 23606-4545 | 2010-06-02 |
| 1275769168 | Anil Mathew Chenthitta | Physical Medicine & Rehabilitation | 19450 Deerfield Ave Ste 280, Leesburg, VA 20176-6821 | 2009-06-05 |
| 1548427461 | Costa George Soteropoulos | Physical Medicine & Rehabilitation | 411-b Park Hill Dr, Fredericksburg, VA 22401 | 2008-05-19 |
| 1003028812 | Christopher A Dawson | Physical Medicine & Rehabilitation | 860 Omni Blvd Ste 115, Newport News, VA 23606-4430 | 2007-05-04 |
| 1356460331 | Integrated Medical Care and Rehab.,pc | Physical Medicine & Rehabilitation | 4600 King Street, Suite 4r, Alexandria, VA 22302 | 2007-03-28 |
| 1518982032 | Joseph Vincent Ferraro | Physical Medicine & Rehabilitation | 2729 King St, Alexandria, VA 22302-4008 | 2006-07-13 |
| 1285668491 | Suneetha Budampati | Physical Medicine & Rehabilitation | 2800 S Shirlington Rd Ste 102, Arlington, VA 22206-3603 | 2006-07-11 |
| 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.