PHS GEN SURG DP306 (NPI# 1457730244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457730244 |
| Entity Type | Organization |
| Organization Name | PHS GEN SURG DP306 |
| Other Organization Name | PROVIDENCE HEALTH SERVICES |
| Practice Address |
1160 Varnum St Ne Depaul 306 Washington DC 20017-2107 |
| Mailing Address |
1160 Varnum St Ne St Catherines's Hall, Room 102 Washington DC 20017-2107 |
| Practice Telephone | 2028544069 |
| Practice Fax Number | 2028547825 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2017-10-09 |
| Authorized Official Name | BEAU HIGGINBOTHAM (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 | 208600000X | Surgery | 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 306 |
| 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 |
| 1124496013 | Phs Internal Medicine Dp311 | Internal Medicine | 1160 Varnum St Ne, Depaul 311, Washington, DC 20017-2107 | 2015-09-09 |
| 1457735029 | Personalized Spine and Pain Care | Clinic/Center | 1160 Varnum St Ne, Suite 212, Washington, DC 20017-2107 | 2015-07-14 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932526407 | Dingchao He | Surgery | 6323 Georgia Ave Nw Ste 101, Washington, DC 20011 | 2014-03-24 |
| 1467893446 | Adeel Ahmed Shamim | Surgery | Howard University Hospital Dept of Surgery, 2041 Georgia Avenue Nw, Washington, DC 20060-0001 | 2013-07-08 |
| 1720423486 | Pejman Radkani | Surgery | 3800 Reservoir Rd Nw Fl 2, Washington, DC 20007 | 2013-05-07 |
| 1700220258 | Hanh Tam Thi Tran | Surgery | 5255 Loughboro Rd Nw Bldg 4th, Washington, DC 20016-2633 | 2013-04-25 |
| 1679916092 | Desmond Uwadiale Ohiowele | Surgery | 2041 Georgia Ave Nw Washington Dc 20059, Washington, DC 20059-6410 | 2013-04-16 |
| 1558623744 | Joseph V Rizzo | Surgery | 58520 Cory Lake Dr, Washington, MI 48094-4206 | 2012-06-13 |
| 1437411998 | Sara Elizabeth Berkey | Surgery | 106 Irving St Nw Ste 2100n, Washington, DC 20010-2927 | 2012-06-11 |
| 1376804732 | Valentine Nofong | Surgery | 2041 Georgia Avenue Nw Howard University Hospital, Washington, DC 20060-1000 | 2012-06-01 |
| 1639455637 | Amy Elizabeth Dubois | Surgery | 1212 E Capitol St Ne, Washington, DC 20002-6244 | 2011-10-23 |
| 1639495799 | Taryn Elise Travis | Surgery | 110 Irving St Nw Rm 3b-55, Washington, DC 20010-3017 | 2010-04-14 |
| 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.