JAIMIE VETTICHIRA SAMUEL (NPI# 1629479563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629479563 |
| Entity Type | Individual |
| Full Name | JAIMIE VETTICHIRA SAMUEL |
| Credential | D.O |
| Practice Address |
100 East St Se Ste 301 Vienna VA 22180 |
| Mailing Address |
8250 Westpark Dr Apt 369 Mc Lean VA 22102-3164 |
| Practice Telephone | 7039385555 |
| Mailing Telephone | 9144093103 |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0102205729 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
100 EAST ST SE STE 301 |
| City | VIENNA |
| State | VA |
| Zip Code | 22180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508233420 | Pegah S Pirowski | Nurse Practitioner | 100 East St Se Ste 301, Vienna, VA 22180-4800 | 2015-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023519386 | Erika Ruiz | Dentist | Ave Miraflores #6439 - A, Tijuana, BAJA CALIFORNIA 22180 | 2018-02-22 |
| 1992220206 | John Alexander | Massage Therapist | 122 Maple Ave W, Vienna, VA 22180 | 2017-08-08 |
| 1548620214 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 2675 Avenir Place, Vienna, VA 22180 | 2016-02-24 |
| 1992163190 | Peter J Mcgarry | Chiropractor | 301 Maple Ave. W. Ste 515, Vienna, VA 22180 | 2016-02-02 |
| 1326454562 | N R Emad Dds PC | Dentist | 307 F Maple Ave. W #100, Vienna, VA 22180 | 2014-07-09 |
| 1881020568 | Albert Juan Garcia | Obstetrics & Gynecology | 926 Fairway Dr., N.e., Vienna, VA 22180 | 2013-09-25 |
| 1295174662 | Sallie Twentyman | Social Worker | 129 Park St Ne Ste 12b, Vienna, VA 22180 | 2013-06-19 |
| 1124390992 | Gilda T. Clarke | Counselor | 133 Park St. Ne, Vienna, VA 22180 | 2012-02-08 |
| 1740573898 | Metro Eyes LLC | Technician/Technologist | 256 E Maple Avenue, Vienna, VA 22180 | 2011-05-24 |
| 1508162801 | Susan Louise Messamore | Registered Nurse | 2504 Patrick St., Vienna, VA 22180 | 2011-02-03 |
| Find all providers in zip 22180 | ||||
| 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 |
|---|---|---|---|---|
| 1164957825 | Katelynn Hillman | Pediatrics | 410 Maple Ave W Ste 5&6, Vienna, VA 22180-4240 | 2017-05-01 |
| 1881956498 | Florencia Maria Segura | Pediatrics | 2235 Cedar Ln Ste 302, Vienna, VA 22182 | 2012-06-10 |
| 1922325380 | Christina G. Ulen | Pediatrics | 100 East St. Se #301, Vienna, VA 22180 | 2010-04-26 |
| 1568639847 | Tuc Thi Nguyen | Pediatrics | 9223 Brian Dr, Vienna, VA 22180-6116 | 2008-05-15 |
| 1326269291 | Mehrdad Javedan | Pediatrics | 8294 A Old Courthouse Rd, Vienna, VA 22182 | 2007-05-01 |
| 1275601627 | Cheryl A Mcgee | Pediatrics | 8294 Old Courthouse Rd Ste A, Vienna, VA 22182-3871 | 2006-12-02 |
| 1295778595 | Michael Martin | Pediatrics | 2235 Cedar Ln, Suite 302, Vienna, VA 22182-5202 | 2006-06-14 |
| 1952351322 | Bahman Shahin Md PC | Pediatrics | 8294 Old Courthouse Rd, Suite A, Vienna, VA 22182 | 2006-05-10 |
| 1083678064 | Jinny K Yoo | Pediatrics | 100 East St Se, Suite 301, Vienna, VA 22180-4800 | 2006-04-14 |
| 1053391540 | Paul E Schweisthal | Pediatrics | 410 Maple Ave W, #5, Vienna, VA 22180-4240 | 2006-01-19 |
| Find all providers in VIENNA | ||||
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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.