ALEXANDRIA LAKE RIDGE PEDIATRICS (NPI# 1417053794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417053794 |
| Entity Type | Organization |
| Organization Name | ALEXANDRIA LAKE RIDGE PEDIATRICS |
| Other Organization Name | LAKE RIDGE OFFICE |
| Practice Address |
1990 Old Bridge Rd Suite 101 Woodbridge VA 22192-2383 |
| Mailing Address |
4660 Kenmore Ave Suite 500 Alexandria VA 22304-1313 |
| Practice Telephone | 7032126600 |
| Practice Fax Number | 7039310961 |
| Mailing Telephone | 7032126600 |
| Mailing Fax Number | 7039310961 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. DEBORAH WEESE (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7032126600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LAKE RIDGE OFFICE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316182116 | Alexandria Lake Ridge Pediatrics | Pediatrics | 9010 Lorton Station Blvd, Suite 100, Lorton, VA 22079 | 2008-12-08 |
| 1194960252 | Alexandria Lake Ridge Pediatrics | Pediatrics | 1500 N Beauregard St, Suite 200, Alexandria, VA 22311-1723 | 2008-12-03 |
| 1548358815 | Alexandria Lake Ridge Pediatrics | Pediatrics | 1500 N Beauregard St, Suite 200, Alexandria, VA 22311-1723 | 2006-10-11 |
| 1649215955 | Alexandria Lake Ridge Pediatrics | Pediatrics | 4660 Kenmore Ave, Suite 500, Alexandria, VA 22304-1313 | 2006-06-19 |
| Street Address |
1990 OLD BRIDGE RD SUITE 101 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-2383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962471623 | Jane Elizabeth Heiertz | Nurse Practitioner | 1990 Old Bridge Rd, Ste 101 All Pediatrics, Woodbridge, VA 22192-2383 | 2006-03-15 |
| 1083197669 | Weng Kay Christina Chen | Nurse Practitioner | 1990 Old Bridge Rd, Woodbridge, VA 22192-2517 | 2018-09-10 |
| 1770673725 | Robert Charles Dost | Dentist | 1990 Old Bridge Rd, Suite 301, Woodbridge, VA 22192-2383 | 2006-10-13 |
| 1285694570 | Eleanor Cooney | Nurse Practitioner | 1990 Old Bridge Rd, Ste 101 Alexandria Lake Ridge Pediatrics, Woodbridge, VA 22192 | 2006-03-23 |
| 1174592356 | Jon M Farber | Pediatrics | 1990 Old Bridge Rd, Woodbridge, VA 22192-2383 | 2006-03-17 |
| 1952370140 | Michael S Caplan | Pediatrics | 1990 Old Bridge Rd, Ste 101, Woodbridge, VA 22192 | 2006-03-17 |
| 1326017146 | Carolyn Sheredy | Nurse Practitioner | 1990 Old Bridge Rd, Ste 101 Alexandria Lake Ridge Pediatrics, Woodbridge, VA 22192-2383 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| 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 |
|---|---|---|---|---|
| 1548518616 | Kavitha Rajarathnam | Pediatrics | 702 Plaza Dr, Woodbridge, NJ 07095-1113 | 2012-08-21 |
| 1740510080 | William Paul Silberberg | Pediatrics | 31 Jenick Ln, Woodbridge, CT 06525-1935 | 2010-01-09 |
| 1154567352 | Manpreet Sidhu | Pediatrics | 12722 Directors Loop, Woodbridge, VA 22192-2462 | 2008-12-18 |
| 1225205222 | David Bendich | Pediatrics | 143 Highview Dr, Woodbridge, NJ 07095-3906 | 2008-05-09 |
| 1285817429 | Lynn Karen Rudich | Pediatrics | 9 N Pease Rd, Woodbridge, CT 06525-1621 | 2007-12-11 |
| 1205031325 | Christine Sunia | Pediatrics | 13001 Summit School Rd, Woodbridge, VA 22192 | 2007-06-19 |
| 1558428953 | Century Pediatrics Inc. | Pediatrics | 2024 Opitz Blvd Ste A, Woodbridge, VA 22191-3388 | 2007-01-03 |
| 1588730790 | Krishnan S. Kumar, M.d., P.C. | Pediatrics | 1900 Opitz Blvd Ste A, Woodbridge, VA 22191-3320 | 2006-11-28 |
| 1346316122 | Leonard Lee Touchette | Pediatrics | 2296 Opitz Blvd Ste 510, Woodbridge, VA 22191-3348 | 2006-11-25 |
| 1033224340 | Nova Pediatrics | Pediatrics | 1483 Old Bridge Rd, Suite 201, Woodbridge, VA 22192-2738 | 2006-08-20 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on ALEXANDRIA LAKE RIDGE PEDIATRICS.
| 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.