OrganizationActive
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
NPI 1114565298 · Health Service Clinic/Center · Fairfax, VA
Provider details
- NPI number
- 1114565298
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
- Organization subpart
- Yes
- Authorized official
- Colleen Swinton, Director, Credentialing(301) 257-2797
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone: (703) 934-5700
Approximate (ZIP-level) locationGet directions
Mailing address
4000 Garden City Dr
Hyattsville, MD 20785-2418
Other names (DBA / former)
- Doing business as
- Fair Oaks Medical Center Dpp
- Doing business as
- Fair Oaks Medical Center Dpp
Registry dates
- Enumerated
- 2019-12-19
- Last updated
- 2025-07-24
- Certified
- 2025-07-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.