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BRIGHTSTAR OF FAIRFAX
NPI 1124374061
Home Health in Fairfax, VA

Active since July 30, 2012CLIA 49D2062595 · Waiver
10517 BRADDOCK RD STE C, FAIRFAX, VA 22032(703) 267-2380(703) 267-2384 Get Directions Write a Review

NPPES record last updated: November 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brightstar Of Fairfax NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRIGHTSTAR OF FAIRFAX (NPI 1124374061) is a healthcare organization registered as a home health in Fairfax, Virginia and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through July 17, 2027, maintains 2 additional practice locations, and lists Robert Withers Massie, President, as its authorized official.

NPPES Registry Identity

NPI1124374061
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameLONE JACK HOLDINGS, INC.
Location Address10517 BRADDOCK RD STE CFairfax, VA 22032-2275
Mailing Address10517 Braddock Rd Ste CFairfax, VA 22032-2275 · (703) 267-2380
Phone(703) 267-2380
Fax(703) 267-2384
Organization SubpartNo
Authorized OfficialRobert Withers MassiePresident · (630) 699-5900
Enumeration DateJuly 30, 2012
Last NPPES UpdateNovember 25, 2024
NPPES CertifiedNovember 25, 2024
✔ NPI 1124374061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Also ListedNursing CareTaxonomy 251J00000X
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
10517 BRADDOCK RD STE C, Fairfax, VA 22032
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Other Names 1

Doing Business AsBrightstar Of Fairfax

Secondary Practice Locations 2

Location 119218 Forest RdLynchburg, VA 24502-4478 · Phone (434) 300-3220 · Fax (434) 300-3221
Location 23243 Electric Rd Ste 2ARoanoke, VA 24018-6440 · Phone (540) 566-5888 · Fax (540) 566-5887

Other Identifiers 1

Other0VA · None

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2062595

Brightstar Care Of Fairfax · Fairfax, VA
Active · expires Jul 17, 2027
CLIA Number49D2062595
Laboratory TypeHome Health Agency
Certificate Effective DateJuly 18, 2025
Certificate Expiration DateJuly 17, 2027
Laboratory DirectorRobert W. Massie
Laboratory Phone(703) 267-2380
Laboratory LocationBrightstar Care Of Fairfax10571C Braddock Road, Fairfax, VA 22030
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lone Jack Holdings, Inc.'s NPI number?

The NPI number for Lone Jack Holdings, Inc. is 1124374061. It was assigned to this organization in the NPPES registry on July 30, 2012. The provider is doing business as Brightstar Of Fairfax.

Where is Lone Jack Holdings, Inc. located?

Lone Jack Holdings, Inc. is located at 10517 Braddock Rd Ste C, Fairfax, VA 22032. The listed phone number is (703) 267-2380.

What is Lone Jack Holdings, Inc.'s specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Lone Jack Holdings, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2062595) is associated with this NPI, valid through July 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lone Jack Holdings, Inc. was last updated on November 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.