Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Organization Health Service Clinic/Center · NPI 1114565298

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc is a Health Service Clinic/Center in Fairfax, Virginia. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone: (703) 934-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1114565298
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationKaiser Foundation Health Plan of the Mid Atlantic States, Inc
Authorized official Colleen Swinton — Director, Credentialing · (301) 257-2797
Other names Fair Oaks Medical Center Dpp; Fair Oaks Medical Center Dpp
NPI enumeratedDecember 19, 2019
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025
Mailing address4000 Garden City Dr, Hyattsville, MD 20785-2418

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