KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC (NPI# 1629223250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629223250 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| Other Organization Name | KAISER PERMANENTE FREDERICKSBURG PHARMACY |
| Practice Address |
1201 Hospital Dr Fredericksburg VA 22401-8428 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 5403683800 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2012-11-13 |
| Authorized Official Name | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165780 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
0201004261 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4841222 | 01 |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Fredericksburg Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265971873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Health Maintenance Organization | 3400 Box Hill Corporate Center Dr, Stes 100 & 200, Abingdon, MD 21009-9998 | 2017-02-15 |
| 1043378656 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Psychologist | 10 Hopkins Plaza, Baltimore, MD 21201-2902 | 2006-12-05 |
| 1740355684 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 815 E Pratt St, Baltimore, MD 21202-4402 | 2006-11-22 |
| 1902971849 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 1396 Piccard Drive, Rockville, MD 20850-4302 | 2006-11-22 |
| 1497820435 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 6501 Loisdale Road, Springfield, VA 22150-1845 | 2006-11-22 |
| 1013082957 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 8028 Richie Highway, Pasadena, MD 21222-1030 | 2006-11-22 |
| 1346315280 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 4920 Campbell Boulevard, Baltimore, MD 21236-5916 | 2006-11-22 |
| 1003981945 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 7070 Samuel Morse Drive, Columbia, MD 21046-3405 | 2006-11-22 |
| 1720153661 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 12201 Plum Orchard Drive, Silver Spring, MD 20910-7803 | 2006-11-22 |
| 1033658521 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 | 2017-02-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 1 Kaiser Plz, Oakland, CA 94612-3610 |
| Street Address |
1201 HOSPITAL DR |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-8428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528139342 | Matthew J Werner | Obstetrics & Gynecology | 1201 Hospital Dr, Kaiser Permanente Fredericksburg Medical Center, Fredericksburg, VA 22401-8428 | 2006-11-13 |
| 1437642519 | Afeez A Salako | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2018-06-13 |
| 1013458157 | Jessica Nomm | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2017-03-08 |
| 1942746086 | Hayley Ann Reed | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2017-01-12 |
| 1023553021 | Pamela Kittoe | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2016-12-29 |
| 1487068268 | Rachel Marquez | Family Medicine | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2014-06-19 |
| 1902147481 | Maura Hackett | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2013-03-08 |
| 1710228101 | Kimberly Huffman | Pharmacist | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2013-03-08 |
| 1700021367 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2008-12-11 |
| 1881849255 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Health Maintenance Organization | 1201 Hospital Dr, Fredericksburg, VA 22401-8428 | 2008-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578120747 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Pharmacy | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-05-23 |
| 1477016368 | Kaiser Foundation Health Plan of The Mid-atlantic States Inc. | Pharmacy | 125 Hospital Center Blvd Ste 110, Stafford, VA 22554-6202 | 2019-04-09 |
| 1073953873 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2013-06-26 |
| 1457416000 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1890 Metro Center Drive, Reston, VA 20190-5276 | 2006-12-26 |
| 1871067207 | Kaiser Foundation Healh Plan of The Mid-atlantic States Inc. | Pharmacy | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2019-01-18 |
| 1538429873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-05-21 |
| 1700159035 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1811031743 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6988 | 2007-02-16 |
| 1740340983 | Kaiser Permanente Ashburn Med Ctr | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6984 | 2006-12-11 |
| 1770643637 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 14139 Potomac Mills Road, Woodbridge, VA 22192 | 2006-12-11 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.
| 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.