Healthcare Provider Details

I. General information

NPI: 1700900834
Provider Name (Legal Business Name): ADRIAN BEAM THOMPSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 WILSON BLVD STE 650
ARLINGTON VA
22209-2455
US

IV. Provider business mailing address

1935 BEAVER LN
MC LEAN VA
22101-5534
US

V. Phone/Fax

Practice location:
  • Phone: 571-267-2325
  • Fax:
Mailing address:
  • Phone: 571-565-6984
  • Fax: 888-885-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA030477
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: