CHANTILLY WALK-IN CLINIC – Clinic/Center, NPI 1972509735

CHANTILLY WALK-IN CLINIC is a healthcare provider. based in Chantilly, Virginia. specializing in Clinic/Center. The organization holds a License No. 0101036326 (VA). The NPI Number for CHANTILLY WALK-IN CLINIC is 1972509735

Main info

Organization
Name
CHANTILLY WALK-IN CLINIC
NPI
1972509735
Phone
(703) 631-0791
Address
PO BOX 221226
Authorized Official
DR. SAMIR NAZAM PHYSICIAN M.D.
Enumeration Date
24 June 2005
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for CHANTILLY WALK-IN CLINIC

  • PO BOX 221226

    CHANTILLY, VA 201531226

    Phone: (703) 631-0791

    Fax: (703) 968-4227

    Type: Mailing

  • 13037 LEE JACKSON HWY

    STE D

    FAIRFAX, VA 220332004

    Phone: (703) 631-0791

    Fax: (703) 968-4227

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090414000430OClinic/Group PracticeDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 20153)

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Reviews

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Frequently asked questions

What NPI should I save for CHANTILLY WALK-IN CLINIC?
Save NPI 1972509735 if you need a stable reference for CHANTILLY WALK-IN CLINIC.
Is CHANTILLY WALK-IN CLINIC active in the national directory?
CHANTILLY WALK-IN CLINIC's public NPI profile is in an active state.
What field does CHANTILLY WALK-IN CLINIC work in?
You can think of CHANTILLY WALK-IN CLINIC as practicing within Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is CHANTILLY WALK-IN CLINIC's primary listing?
We display Chantilly, Virginia because that is what the record indicates for CHANTILLY WALK-IN CLINIC.
What if Chantilly, Virginia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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