Provider Demographics
NPI:1467479162
Name:IRMINDRA S RANA, MD PLC
Entity Type:Organization
Organization Name:IRMINDRA S RANA, MD PLC
Other - Org Name:KIDNEY DISEASES, HYPERTENSION AND PRIMARY CARE OF VIRGINIA, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRMINDRA
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-444-5084
Mailing Address - Street 1:1985 AIKEN HILL COURT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1548
Mailing Address - Country:US
Mailing Address - Phone:703-444-5084
Mailing Address - Fax:703-444-4548
Practice Address - Street 1:611 S CARLIN SPRINGS RD STE 203
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1078
Practice Address - Country:US
Practice Address - Phone:703-998-0480
Practice Address - Fax:703-888-2971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233375207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010083869Medicaid
DCI02996Medicare UPIN
VA010083869Medicaid