PHS INTERNAL MEDICINE DP311 (NPI# 1124496013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124496013 |
| Entity Type | Organization |
| Organization Name | PHS INTERNAL MEDICINE DP311 |
| Other Organization Name | PROVIDENCE HEALTH SERVICES |
| Practice Address |
1160 Varnum St Ne Depaul 311 Washington DC 20017-2107 |
| Mailing Address |
1160 Varnum St Ne St Catherine's Hall, Room 102 Washington DC 20017-2107 |
| Practice Telephone | 2028544470 |
| Practice Fax Number | 2028544471 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2017-10-10 |
| Authorized Official Name | BEAU HIGGINBOTHAM (VICE PRESIDENT/COO) |
| Authorized Official Telephone | 4103683162 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | HFD01-0212 | DC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Health Services | Doing Business As Name - Organization |
| Street Address |
1160 VARNUM ST NE DEPAUL 311 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20017-2107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619975349 | Edward Anthony Rankin | Orthopaedic Surgery | 1160 Varnum St Ne, 312, Washington, DC 20017-2107 | 2005-07-07 |
| 1275150666 | Abena Ameyaa Effah Habia | Social Worker | 1160 Varnum St Ne, Washington, DC 20017-2107 | 2020-07-01 |
| 1669922423 | Brittany Page | Dietitian, Registered | 1160 Varnum St Ne, Depaul 110, Washington, DC 20017-2107 | 2016-10-05 |
| 1396291480 | Selam Zewoldi | Physician Assistant | 1160 Varnum St Ne, St Catherine's Hall, Suite 200, Washington, DC 20017-2107 | 2016-08-29 |
| 1841648292 | Dental Professional Associates LLC | Durable Medical Equipment & Medical Supplies | 1160 Varnum St Ne, #006, Washington, DC 20017-2107 | 2016-05-26 |
| 1457735029 | Personalized Spine and Pain Care | Clinic/Center | 1160 Varnum St Ne, Suite 212, Washington, DC 20017-2107 | 2015-07-14 |
| 1457730244 | Phs Gen Surg Dp306 | Surgery | 1160 Varnum St Ne, Depaul 306, Washington, DC 20017-2107 | 2015-05-26 |
| 1336532035 | Erin Keehan | Nurse Practitioner | 1160 Varnum St Ne, Suite 100, Washington, DC 20017-2107 | 2015-03-05 |
| 1730571530 | Rachel Merton | Nurse Practitioner | 1160 Varnum St Ne, Suite 312, Washington, DC 20017-2107 | 2015-03-03 |
| 1225428865 | Diabetic Eye & Macular Disease Specialists LLC | Ophthalmology | 1160 Varnum St Ne, Suite 208, Washington, DC 20017-2107 | 2015-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588215479 | Janet Achankeng Folem | Psychologist | 7100 Varnum St Ne, Suit 218, Washington, DC 20017 | 2019-09-23 |
| 1013475284 | Raphaelia Agnes Johnson-phillips | Technician | 440 Taylor St. Ne Building B Apt 22, Washington Dc, DC 20017 | 2019-03-06 |
| 1528551413 | Harpreet Saluja | Student in an Organized Health Care Education/Training Program | 1150 Varnum St Ne, Providence Hospital Im Department, Washington, DC 20017 | 2018-06-14 |
| 1134638042 | Jane Hayashi-kim | Speech-Language Pathologist | 3910 9th St Ne, Apartment 3, Washington, DC 20017 | 2017-09-22 |
| 1346766102 | Aaliyah Gabrielle Jones | Technician | 611edgewood Ne, Washington, DC 20017 | 2017-08-14 |
| 1417479197 | Javalin Singh | Home Health Aide | Hsc Pediatric Center 1731 Bunker Hill Rd, Washington, DC 20017 | 2017-07-13 |
| 1386174175 | Genevieve Wells | Home Health Aide | 601 Edgewood St. Ne, Apt 706, Washington, DC 20017 | 2017-06-14 |
| 1487183810 | Valerie Anne Pierre | Student in an Organized Health Care Education/Training Program | 1150 Varnum Street, N.e., Acc 209, Washington, DC 20017 | 2017-06-08 |
| 1639600984 | Liliana Tatum | Counselor | 1428 Hamlin Street Ne, Washington, DC 20017 | 2017-03-27 |
| 1750835435 | Marie Hortense Mabou Sando | Home Health Aide | 1416 9th Street Nwdc, Washington, DC 20017 | 2016-08-10 |
| Find all providers in zip 20017 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581576 | Brittney Boxley | Internal Medicine | 1113 Clifton St Nw, Washington, DC 20009-5206 | 2020-09-08 |
| 1154948362 | Hibiscus Medical Pllc | Internal Medicine | 1268 Delafield Pl Ne, Washington, DC 20017-2809 | 2020-07-03 |
| 1104454594 | Hoangmai Huu Pham | Internal Medicine | 1231 C St Ne, Washington, DC 20002-6368 | 2020-03-31 |
| 1992351399 | Richard Senzer Md LLC | Internal Medicine | 279 State Route 31 S Ste 1, Washington, NJ 07882-4099 | 2019-08-13 |
| 1336700160 | Northrium Health LLC | Internal Medicine | 1673 K Street #300 Nw, Washington, DC 20006 | 2019-06-24 |
| 1780158873 | Clinicians In Telemedicine LLC | Internal Medicine | 1678 Beeman Rd, Washington, WV 26181-5360 | 2019-01-11 |
| 1669942983 | It Hospitalist Services | Internal Medicine | United Medical Center, 1310 Southern Ave., Se, Washington, DC 20032-4623 | 2018-11-29 |
| 1619447380 | Michael Waters | Internal Medicine | 10 Samuel Dr, Washington, PA 15301-3206 | 2018-11-26 |
| 1851866198 | Washington Medical LLC | Internal Medicine | 1140 Varnum St Ne Ste 203, Washington, DC 20017-2153 | 2018-10-12 |
| 1124512819 | Internal Medicine Colleagues Pllc | Internal Medicine | 2021 K St Nw Ste 404, Washington, DC 20006-1003 | 2018-06-18 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20017 |
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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.