PAVILION PACE, LLC
NPI 1164310496
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Annandale, VA

Q: What is Pavilion Pace, LLC's NPI number?

The NPI number for Pavilion Pace, LLC is 1164310496. It was assigned to this organization in the NPPES registry on June 25, 2025.

Q: What is Pavilion Pace, LLC's specialty?

The primary specialty registered for this NPI is Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

Active since June 25, 2025

4115 ANNANDALE RD STE 100, ANNANDALE, VA 22003(240) 346-7488(703) 226-5604 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Pavilion Pace, Llc NPPES

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

PAVILION PACE, LLC (NPI 1164310496) is a healthcare organization registered as a program of all-inclusive care for the elderly (pace) provider organization in Annandale, Virginia and active in the NPI registry since June 2025. The organization lists Gibson Erhunmwunse, Ceo, as its authorized official.

NPPES Registry Identity

NPI1164310496

Entity TypeOrganization

Primary Taxonomy251T00000X

Legal Business NamePAVILION PACE, LLC

Location Address4115 ANNANDALE RD STE 100Annandale, VA 22003-2583

Mailing Address4115 Annandale Rd Ste 100Annandale, VA 22003-2583 · (240) 346-7488 · Fax (703) 226-5604

Phone(240) 346-7488

Fax(703) 226-5604

Organization SubpartNo

Authorized OfficialGibson ErhunmwunseCeo · (240) 346-7488

Enumeration DateJune 25, 2025

NPPES CertifiedJune 25, 2025

✔ NPI 1164310496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationAgencies

Taxonomy Code251T00000X

Definition

A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

4115 ANNANDALE RD STE 100, Annandale, VA 22003

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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 Pavilion Pace, LLC's NPI number?

The NPI number for Pavilion Pace, LLC is 1164310496. It was assigned to this organization in the NPPES registry on June 25, 2025.

Where is Pavilion Pace, LLC located?

Pavilion Pace, LLC is located at 4115 Annandale Rd Ste 100, Annandale, VA 22003. The listed phone number is (240) 346-7488.

What is Pavilion Pace, LLC's specialty?

The primary specialty registered for this NPI is Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

When was this NPI record last updated?

The NPPES record for Pavilion Pace, LLC was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.