INOVA RESTON MRI CENTER LLC (NPI# 1750616397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750616397 |
| Entity Type | Organization |
| Organization Name | INOVA RESTON MRI CENTER LLC |
| Other Organization Name | THE FAIRFAX MRI CENTER AT RESTON |
| Practice Address |
100 Elden St Suite 16m Herndon VA 20170-4873 |
| Mailing Address |
2722 Merrilee Dr Ste 230 Fairfax VA 22031-4420 |
| Practice Telephone | 7034819400 |
| Practice Fax Number | 7037888484 |
| Mailing Telephone | 7037888477 |
| Mailing Fax Number | 7036982176 |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2011-08-17 |
| Authorized Official Name | H PATRICK WALTER (PRESIDENT) |
| Authorized Official Telephone | 7037888477 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1972838993 | 05 | |
| WV | 3810017668 | 05 | |
| VA | AETNA - PPO | 9616343 | 01 |
| VA | AETNA HMO | 6123294 | 01 |
| VA | UHC | 3120417 | 01 |
| Other Name | Type Code |
|---|---|
| THE FAIRFAX MRI CENTER AT RESTON | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619265766 | Inova Reston Mri Center LLC | Clinic/Center | 7799 Leesburg Pike, Suite 104s, Falls Church, VA 22043-2408 | 2011-07-11 |
| 1952636581 | Inova Reston Mri Center LLC | Clinic/Center | 8503 Arlington Blvd, Suite Ll100, Fairfax, VA 22031-4628 | 2009-10-15 |
| 1972838993 | Inova Reston Mri Center LLC | Radiology | 100 Elden St, Suite 16m, Herndon, VA 20170-4873 | 2009-10-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Inova Reston MRI Center LLC | 8110 Gatehouse Rd Ste 200 East Tower, Falls Church, Virginia 22042-1210 |
| Street Address |
100 ELDEN ST SUITE 16M |
| City | HERNDON |
| State | VA |
| Zip Code | 20170-4873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639174642 | Donna Lynn Schuster | Allergy & Immunology | 100 Elden St, Ste 10, Herndon, VA 20170 | 2005-06-16 |
| 1578941407 | Anna Marie Lisowski | Nurse Practitioner | 100 Elden St, Suite 10, Herndon, VA 20170-4873 | 2015-05-12 |
| 1558663112 | Merrill Lee Myers | Allergy & Immunology | 100 Elden St, Suite 10, Herndon, VA 20170 | 2010-12-02 |
| 1972838993 | Inova Reston Mri Center LLC | Radiology | 100 Elden St, Suite 16m, Herndon, VA 20170-4873 | 2009-10-08 |
| 1871779496 | Rohini Wijetilleke | Family Medicine | 100 Elden St, Suite 14, Herndon, VA 20170-4873 | 2008-01-14 |
| 1003092974 | Fairfax Radiological Consultants PC | Specialist | 100 Elden St, Ste 16, Herndon, VA 20170-4873 | 2008-01-10 |
| 1679658363 | Adult and Pediatric Healthcare | Pediatrics | 100 Elden St, Suite 10, Herndon, VA 20170-4873 | 2006-10-25 |
| 1164427175 | Ngoc Vu | Allergy & Immunology | 100 Elden St, Ste 10, Herndon, VA 20170-4833 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391506 | Ashley Powell | Counselor | 435a Carlisle Dr Ste 103, Herndon, VA 20170 | 2019-05-13 |
| 1841781176 | Virginia Medical Transport, LLC. | Ambulance | 360 Herndon Pkwy Ste 700, Herndon, VA 20170 | 2018-05-22 |
| 1508378332 | Warm Touch Home Care LLC | In Home Supportive Care | 492 Alabama Dr, Herndon, VA 20170 | 2017-11-02 |
| 1154847853 | Elhady Dental Pllc | Dentist | 131 Elden St #130, Herndon, VA 20170 | 2017-08-15 |
| 1841736956 | Julian Badawy | Social Worker | 425 Carlisle Drive, Herndon, VA 20170 | 2017-01-12 |
| 1942742861 | Dr. Mojdeh Vessali Family Dentistry | Dentist | 505 Huntmar Park Drive, #150, Herndon, VA 20170 | 2016-11-09 |
| 1043614308 | Scott Taylor Young | Chiropractor | 905 Herndon Parkway, Suite B, Herndon, VA 20170 | 2014-10-15 |
| 1942614706 | Desiree Debutts Farren | Counselor | 425-b Carlisle Drive, Herndon, VA 20170 | 2014-06-19 |
| 1003229006 | Angels Home Health Care LLC | Home Health | 626 Grant Street, Suite # K, Herndon, VA 20170 | 2014-06-06 |
| 1457608986 | Dental Center of Herndon | Dentist | 1110 Elden St., Suite E108, Herndon, VA 20170 | 2012-08-15 |
| Find all providers in zip 20170 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
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| 1851338222 | Buford Road Imaging LLC | Clinic/Center | 2612 Buford Road, Richmond, VA 23235-3422 | 2006-06-02 |
| 1538116108 | Chesterfield Imaging LLC | Clinic/Center | 13636 Hull Street Rd, Midlothian, VA 23112-2108 | 2006-05-28 |
| 1508405317 | Ifrc, LLC | Clinic/Center | 2722 Merrilee Dr Ste 230, Fairfax, VA 22031-4400 | 2019-12-26 |
| 1619526720 | Inova Health Care Services | Clinic/Center | 8081 Innovation Park Dr, Fairfax, VA 22031-4867 | 2019-09-11 |
| 1700234580 | Lewisgale Medical Center, LLC | Clinic/Center | 65 Shenandoah Ave, Suite 103, Daleville, VA 24083-3252 | 2016-06-02 |
| 1619265766 | Inova Reston Mri Center LLC | Clinic/Center | 7799 Leesburg Pike, Suite 104s, Falls Church, VA 22043-2408 | 2011-07-11 |
| 1700190170 | Orthopaedic Surgery and Sports Medicine Specialists | Clinic/Center | 250 Nat Turner Blvd S, Newport News, VA 23606-2899 | 2010-07-28 |
| 1972731057 | Medical Circle, LLC | Clinic/Center | 1830 Amherst St, Winchester, VA 22601-2808 | 2009-06-26 |
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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.