MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC (NPI# 1861437154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861437154 |
| Entity Type | Organization |
| Organization Name | MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC |
| Other Organization Name | MANORCARE HEALTH SERVICES - FAIR OAKS |
| Practice Address |
12475 Lee Jackson Memorial Hwy Fairfax VA 22033-2803 |
| Mailing Address |
333 N Summit St Toledo OH 43604-2615 |
| Practice Telephone | 7033527172 |
| Practice Fax Number | 7032183200 |
| Mailing Telephone | 4192525500 |
| Mailing Fax Number | 8773859446 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2017-05-12 |
| Authorized Official Name | MR. MARTIN D ALLEN (DIRECTOR) |
| Authorized Official Telephone | 4192525734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NH2619 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1861437154 | 05 |
| Other Name | Type Code |
|---|---|
| ManorCare Health Services - Fair Oaks | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Manor Care-Fair Oaks of Fairfax VA LLC | 333 N Summit St, Toledo, Ohio 43604 |
| Street Address |
12475 LEE JACKSON MEMORIAL HWY |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-2803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578049615 | Supriya Ravuru | Physical Therapist | 12475 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2803 | 2018-07-12 |
| 1538655972 | Vipula Puntikura | Physical Therapy Assistant | 12475 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2803 | 2018-07-09 |
| 1346621976 | Keiko H Kuykendall | Nurse Practitioner | 12475 Lee Jackson Memorial Hwy, Heartland Care Partners, Fairfax, VA 22033-2803 | 2015-06-09 |
| 1033523048 | Jaclyn Rotier | Occupational Therapist | 12475 Lee Jackson Memorial Hwy, Fairfax, VA 22033-2803 | 2014-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1659418473 | Caremeridian, LLC | Skilled Nursing Facility | 2390 Sir Francis Drake Blvd, Fairfax, CA 94930-1127 | 2007-01-31 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1710963251 | Fairfax Community Home Inc | Skilled Nursing Facility | 300 10th Ave Se, Fairfax, MN 55332-2149 | 2005-12-16 |
| 1972592533 | The Temple Foundation Inc. | Skilled Nursing Facility | 9229 Arlington Blvd, Fairfax, VA 22031-2504 | 2005-10-17 |
| 1386636116 | Fairfax Nursing Center, Inc | Skilled Nursing Facility | 10701 Main St, Fairfax, VA 22030-6904 | 2005-08-18 |
| 1033718382 | Fairfax Operator LLC | Skilled Nursing Facility | 10701 Main St, Fairfax, VA 22030-6904 | 2020-10-19 |
| 1912032012 | Inova Health System Services | Skilled Nursing Facility | 4315 Chain Bridge Rd, Fairfax, VA 22030-3061 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
| 1669823373 | Allyson Clark | Skilled Nursing Facility | 490 Paradise Ln, Saxe, VA 23967-5529 | 2016-06-23 |
| 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.