ADVANCED DIGESTIVE CARE, LLC (NPI# 1629462171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629462171 |
Entity Type | Organization |
Organization Name | ADVANCED DIGESTIVE CARE, LLC |
Practice Address |
14010 Smoketown Rd Suite 117 Woodbridge VA 22192 |
Mailing Address |
14010 Smoketown Rd Suite 117 Woodbridge VA 22192-4722 |
Practice Telephone | 7035800181 |
Practice Fax Number | 7038978763 |
Mailing Telephone | 7035800181 |
Mailing Fax Number | 7038978763 |
Enumeration Date | 2015-03-23 |
Last Update Date | 2018-07-18 |
Authorized Official Name | KENNETH N JOSOVITZ (ADMINISTRATOR) |
Authorized Official Telephone | 7035800181 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
Y | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
14010 SMOKETOWN RD SUITE 117 |
City | WOODBRIDGE |
State | VA |
Zip Code | 22192 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922094580 | Kenneth Neil Josovitz | Internal Medicine | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4704 | 2005-09-20 |
1639686009 | Mahnoor Moin | Physician Assistant | 14010 Smoketown Rd, Woodbridge, VA 22192-4722 | 2018-01-05 |
1922548130 | Nitiksha Patel | Physician Assistant | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2017-03-07 |
1548657117 | Tina Polley | Nurse Practitioner | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2015-04-22 |
1982097770 | Associates In Gastroenterology, PC | Nurse Practitioner | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2015-03-18 |
1679881486 | Carlyle Fairfax Hooff Casella | Physician Assistant | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2010-09-15 |
1609019520 | Ali Farhad Kazemi | Internal Medicine | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2009-04-07 |
1346403920 | Anisha Thadani | Internal Medicine | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2008-07-03 |
1326205113 | Benjamin Edward Young II | Internal Medicine | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4704 | 2008-05-20 |
1457546236 | Arunan Vamadevan | Internal Medicine | 14010 Smoketown Rd, Suite 117, Woodbridge, VA 22192-4722 | 2007-09-13 |
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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 | 207ZP0105X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pathology |
Specialization | Clinical Pathology/Laboratory Medicine |
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
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---|---|---|---|---|
1437710415 | Stagezero Life Sciences Inc | Pathology | 8751 Park Central Dr Ste 200, Richmond, VA 23227-1162 | 2019-06-21 |
1003251141 | Foot and Ankle Clinic of The Virginias Inc | Pathology | 2036 Leatherwood Ln, Bluefield, VA 24605-2020 | 2013-05-02 |
1851303317 | Lou Ann Young Maes | Pathology | 611 W Brambleton Ave, Norfolk, VA 23510-1004 | 2006-08-13 |
1306866264 | Pamela Clark | Pathology | Uva Old Medical School, Hospital Drive, Charlottesville, VA 22908-0001 | 2006-07-20 |
1407176969 | Junqi Qian | Pathology | 9101 Stony Point Dr, Richmond, VA 23235 | 2010-06-08 |
1275709123 | Clinical Pathology Associates of Fredericksburg LLC | Pathology | 1001 Sam Perry Boulevard, Fredericksburg, VA 22401 | 2008-05-01 |
1710198197 | Marie Christine Do | Pathology | 1250 E Marshall St, Pathology, Richmond, VA 23298-5051 | 2007-05-25 |
1205059359 | Mary Teresa Padilla | Pathology | 9105 Stony Point Pkwy, Richmond, VA 23235-1979 | 2007-04-10 |
1215907399 | Elvira Tomescu | Pathology | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2006-01-23 |
1619954351 | James Allen Henry | Pathology | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2005-12-23 |
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City | WOODBRIDGE |
Zip Code | 22192 |
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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.