DR. CHRISTINA MARIE PEROUTKA (NPI# 1114269479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114269479 |
| Entity Type | Individual |
| Full Name | DR. CHRISTINA MARIE PEROUTKA |
| Credential | MD |
| Practice Address |
1204 W Main St Charlottesville VA 22903 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 4349240123 |
| Practice Fax Number | 4342433300 |
| Mailing Telephone | 4342951000 |
| Mailing Fax Number | 4349724266 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0101266978 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Orleans St, Baltimore, MD 212870010 | 4109552727 | |
| 10 Center Drive, Building 10 Crc Rm 32551-msc1205, Bethesda, MD 20892 | 3014967125 | |
| 629 Cedar Creek Grade, Winchester, VA 226012786 | 4346783950 | 5406783954 |
| Street Address |
1204 W MAIN ST |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980287 | Ann Lenox Kellams | Pediatrics | 1204 W Main St, Charlottesville, VA 22903-2824 | 2005-08-31 |
| 1982210357 | Olivia Oriana Obertello | Dietitian, Registered | 1204 W Main St, Charlottesville, VA 22903-2824 | 2020-09-21 |
| 1417563180 | Caitlin E Anderson | Psychologist | 1204 W Main St, Charlottesville, VA 22903-2824 | 2020-09-18 |
| 1821611286 | Mackenzie Trapp | Genetic Counselor, MS | 1204 W Main St, Charlottesville, VA 22903-2824 | 2020-05-20 |
| 1740836287 | Sarah Burnett | Pediatrics | 1204 W Main St, Charlottesville, VA 22903-2824 | 2019-08-12 |
| 1609439207 | Meredith Jordan | Student in an Organized Health Care Education/Training Program | 1204 W Main St, Charlottesville, VA 22903-2824 | 2019-04-18 |
| 1376007328 | Kaitlyn Geib | Nurse Practitioner | 1204 W Main St, Charlottesville, VA 22903-2824 | 2019-01-24 |
| 1275017147 | Haley F. Stephens | Pediatrics | 1204 W Main St, Charlottesville, VA 22903-2824 | 2018-09-18 |
| 1114414919 | Shelley Towner | Genetic Counselor, MS | 1204 W Main St, Charlottesville, VA 22903-2824 | 2018-04-17 |
| 1891291944 | Elina Bank | Dietitian, Registered | 1204 W Main St, Charlottesville, VA 22903 | 2018-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326671009 | Ticynn Symone London | Specialist/Technologist | 723 Retriever Run, Ticynn London, Charlottesville, VA 22903 | 2020-02-20 |
| 1043853542 | Elaine Mccall | Dietitian, Registered | 1335 Jefferson Park Ave, Charlottesville, VA 22903 | 2019-10-28 |
| 1205480753 | Sean Robert Bennett | Clinic/Center | 433 Ednam Drive, Charlottesville, VA 22903 | 2019-08-01 |
| 1922562818 | Lynn Owen Taggart | Student in an Organized Health Care Education/Training Program | 300 Grassmere Rd, Charlottesville, VA 22903 | 2019-01-25 |
| 1831636166 | Sarah Michelle Richin | Social Worker | 709 A West Main St, Charlottesville, VA 22903 | 2017-01-25 |
| 1962868851 | Kelly Stewart Maurer | Counselor | 3101 Fontaine Avenue, Charlottesville, VA 22903 | 2016-01-07 |
| 1831592039 | Bearley Dental PC | Dentist | 901 Preston Ave, Suite 200, Charlottesville, VA 22903 | 2014-10-01 |
| 1730437823 | Frances Eva Demmerle | Neuromusculoskeletal Medicine & OMM | 1149 Rose Hill Dr., Charlottesville, VA 22903 | 2012-08-21 |
| 1801142229 | University of Virginia | General Acute Care Hospital | 1925 Beechcrest Court, Charlottesville, VA 22903 | 2012-08-03 |
| 1407123516 | Laura P. Handler | Counselor | 500 Old Lynchburg Rd., Region Ten Csb, Charlottesville, VA 22903 | 2011-11-18 |
| Find all providers in zip 22903 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619363058 | Elizabeth Dexter-rice | Pediatrics | 1204 W Main Street Floor 6, Charlottesville, VA 22908-0816 | 2015-04-13 |
| 1578958526 | Kaitlin R. Blackard | Pediatrics | 1204 Main St Fl 6, Charlottesville, VA 22908-0816 | 2015-04-06 |
| 1215270558 | Erin Suzanne Kalan | Pediatrics | 111 Apple Tree Rd, Charlottesville, VA 22903-2906 | 2013-04-05 |
| 1760688105 | Valentina J. Intagliata | Pediatrics | 1105 W Main St Rm 1421, Charlottesville, VA 22903-2821 | 2007-06-22 |
| 1053526210 | Jason M Glover | Pediatrics | Lee Street 4th Floor, Charlottesville, VA 22908-0001 | 2007-05-11 |
| 1447329081 | Heather R. Quillian | Pediatrics | 2955 Ivy Rd Ste 303, Charlottesville, VA 22903-9353 | 2006-11-07 |
| 1841370566 | Kathryn A Cook | Pediatrics | 895 B Rio East Court, Charlottesville, VA 22901 | 2006-10-17 |
| 1538252291 | Eric Norman Rydland | Pediatrics | 1921 Commonwealth Dr, Charlottesville, VA 22901-2382 | 2006-10-02 |
| 1487681581 | James Linn Plews-ogan | Pediatrics | 1412 Sachem Pl, Suite 203, Charlottesville, VA 22901-2499 | 2006-06-26 |
| 1104869767 | Amy L. Wrentmore | Pediatrics | Lee St Fl 4, Charlottesville, VA 22908-0001 | 2006-06-13 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.