PROVIDENCE HEALTH SERVICES, INC (NPI# 1619245222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619245222 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SERVICES, INC |
| Other Organization Name | PROVIDENCE HEALTH SERVICES |
| Practice Address |
128 M St Nw Washington DC 20001-1205 |
| Mailing Address |
1150 Varnum St Ne Rm 407 Washington DC 20017-2180 |
| Practice Telephone | 2026823840 |
| Practice Fax Number | 2026823854 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | MR. BEAU HIGGINBOTHAM (VICE PRESIDENT/COO) |
| Authorized Official Telephone | 4106383162 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 023435102 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Health Services | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1150 Varnum St Ne Rm 407, Washington, DC 200172180 | 2028544069 | 2028547825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356859334 | Providence Health Services, Inc | Specialist | 1150 Varnum St Ne Ste 300, Washington, DC 20017-2180 | 2018-01-12 |
| 1609031632 | Providence Health Services, Inc | Psychiatry & Neurology | 1140 Varnum St Ne Ste 100, Washington, DC 20017 | 2008-07-18 |
| 1598313595 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-09-03 |
| 1740795293 | Providence Health Services, Inc | Nurse Anesthetist, Certified Registered | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-12-06 |
| 1679087365 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-11-17 |
| 1730690801 | Providence Health Services, Inc | Clinic/Center | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2017-10-17 |
| 1972012615 | Providence Health Services, Inc | Obstetrics & Gynecology | 1150 Varnum St Ne, St Catherine's Hall, 2nd Floor, Washington, DC 20017-2107 | 2017-09-26 |
| 1689005720 | Providence Health Services, Inc | General Acute Care Hospital | 1160 Varnum St Ne, Depaul 312, Washington, DC 20017-2107 | 2013-11-27 |
| 1366710766 | Providence Health Services, Inc | General Acute Care Hospital | 1140 Varnum St Ne, Pmb 200, Washington, DC 20017-2151 | 2011-12-13 |
| Street Address |
128 M ST NW |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20001-1205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821101767 | Cecillia Tsao | Internal Medicine | 128 M St Nw, Washington, DC 20001-1205 | 2006-08-16 |
| 1518452291 | Bright Beginnings,inc | Psychologist | 128 M St Nw, Washington, DC 20001-1205 | 2018-06-26 |
| 1972055457 | Deborah Victoria Suchman | Nurse Practitioner | 128 M St Nw, Washington, DC 20001-1205 | 2016-10-31 |
| 1487019030 | Yiesak W. Asfaw | Nurse Practitioner | 128 M St Nw, Washington, DC 20001-1205 | 2015-12-28 |
| 1902193030 | Mary Josephine Stein | Nurse Practitioner | 128 M St Nw, Perry Family Health Center, Washington, DC 20001-1205 | 2011-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762673 | Muslimah Annjinnah Shaffi | Home Health Aide | Perry Health System, 128 M Street N.w., Washington Dc, DC 20001 | 2020-05-21 |
| 1275197378 | Marica Donisha Robinette | Home Health | 471 G Place, Nw, #32, Washington, DC 20001 | 2019-04-24 |
| 1689147571 | Maria R Barrera | Counselor | 440 L St Nw, Unit 610, Washington, DC 20001 | 2019-01-03 |
| 1083185086 | Corneesha Donielle Banks | Technician | 307 Kst Nw, #309, Washington, DC 20001 | 2018-12-17 |
| 1548730138 | Briana Shayron Smith | Technician | 150 Q St Ne 1427, Washington, DC 20001 | 2018-11-27 |
| 1235609876 | Edward Bruce Lawson | Technician | 3400 Banneker Dr 425, Northeast, DC 20001 | 2018-11-27 |
| 1740760750 | Minchu Chen | Acupuncturist | 1410, 9th Street Nw #1, First Floor, Washington, DC 20001 | 2018-08-19 |
| 1821574005 | Kimberly Ann Bell | Home Health Aide | 27 O St Nw #4, Washington, DC 20001 | 2018-07-11 |
| 1558859926 | Joan Avis Williams | Home Health Aide | Unique Resident Care Center, 901 First Street Nw, Washington, DE 20001 | 2018-05-01 |
| 1497274088 | Gabriela Andrea Jatene | Speech-Language Pathologist | 450 K Street Nw, Apt 306, Washington, DC 20001 | 2017-09-14 |
| Find all providers in zip 20001 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598314908 | Centerville Clinics Inc | Family Medicine | Centerville Clinics - City Mission Site, 84 W Wheeling Street, Washington, PA 15301-6918 | 2019-09-09 |
| 1912487380 | James Elwood Richardson | Family Medicine | 270 Shady Ln, Washington, PA 15301-2536 | 2018-08-15 |
| 1851829709 | Jason Snavely | Family Medicine | 95 Leonard Ave Bldg 22nd, Washington, PA 15301-3368 | 2017-05-23 |
| 1760923361 | Natasha Khawaja | Family Medicine | Upper Cardozo Community Health Center, 320 14th Street Nw, Washington, DC 20009 | 2017-03-15 |
| 1992158364 | Ok Hee Rhee | Family Medicine | 6 Club House Dr Ste 102, Washington, NJ 07882-2213 | 2016-07-20 |
| 1154738193 | Presidential Healthcare Center | Family Medicine | 5215 Loughboro Road Nw, Suite 470, Washington, DC 20016 | 2014-07-22 |
| 1174936686 | Andrew Moss | Family Medicine | 6121 32nd St Nw, Washington, DC 20015-2459 | 2014-06-03 |
| 1417367814 | Fri Awasum | Family Medicine | 2041 Georgia Ave Nw Faclty Practice Plan Suite 3200, Washington, DC 20060-7232 | 2014-05-07 |
| 1982024378 | Robert Latham Baillieu | Family Medicine | 1400 I (eye) Street Nw, Suite 825, Washington, DC 20005 | 2014-04-24 |
| 1003233453 | Jennifer Carlton | Family Medicine | 64580 Van Dyke Rd Ste C, Washington, MI 48095-2811 | 2014-03-24 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20001 |
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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.