Healthcare Provider Details

I. General information

NPI: 1851214381
Provider Name (Legal Business Name): ZION MEDICAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 COLUMBIA PIKE
ANNANDALE VA
22003-3106
US

IV. Provider business mailing address

9429 MIRROR POND DR
FAIRFAX VA
22032-1352
US

V. Phone/Fax

Practice location:
  • Phone: 703-634-3180
  • Fax:
Mailing address:
  • Phone: 703-801-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH-JANE NGONGBO
Title or Position: DIRECTOR
Credential:
Phone: 703-887-7758