MACKENZIE GONDER (NPI# 1679972608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679972608 |
| Entity Type | Individual |
| Full Name | MACKENZIE GONDER |
| Practice Address |
1860 Town Center Dr Ste 240 Reston VA 20190-5899 |
| Practice Telephone | 7037961986 |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1860 TOWN CENTER DR STE 240 |
| City | RESTON |
| State | VA |
| Zip Code | 20190-5899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427487784 | Samantha Major Frazier | Physician Assistant | 1860 Town Center Dr Ste 240, Reston, VA 20190-5899 | 2013-11-07 |
| 1598322406 | Agata Alicja Greer | Physician Assistant | 1860 Town Center Dr Ste 240, Reston, VA 20190-5899 | 2019-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912548470 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1906 Reston Metro Plaza, Suite 100, Reston, VA 20190 | 2019-10-04 |
| 1205483260 | Northern Virginia Applied Behavior Analysis, L.L.C. | Behavioral Analyst | 1984 Issac Newton Square West, Suite 204, Reston, VA 20190 | 2019-08-23 |
| 1336796481 | Sandra Chiunda | Nurse Practitioner | 11484 Washington Plaza W 3rd Floor, Reston, VA 20190 | 2019-08-23 |
| 1891357232 | Beyond Counseling, Inc. | Clinic/Center | 11250 Roger Bacon Dr., Atrium 5, Reston, VA 20190 | 2019-07-06 |
| 1003470063 | Sarah Katharina Jungnitsch | Registered Nurse | Reston Anesthesia Associates, 11341 Sunset Hills Road, Reston, VA 20190 | 2019-04-25 |
| 1194202341 | May Health Care Services Inc | Home Health | 12110 Sunset Hills Road Suite 600, Reston, VA 20190 | 2018-07-20 |
| 1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
| 1760901045 | Kristen Kelly | Dietitian, Registered | 11703 Bowman Green Drive, Lower Level, Reston, VA 20190 | 2017-09-18 |
| 1245778992 | Sarah Christine Bernstein | Occupational Therapist | 1860 Town Center Drive Ste, Suite 300, Reston, VA 20190 | 2017-02-02 |
| 1023495298 | Phillip Nguyen | Dentist | 1800 Town Center Dr Ste 116, Reston, VA 20190 | 2015-04-27 |
| Find all providers in zip 20190 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126215 | Nickolas Patrick Forsberg | Physician Assistant | 11800 Sunrise Valley Dr Fl 8, Reston, VA 20191-5300 | 2020-08-27 |
| 1902457385 | Abigail P Nelson | Physician Assistant | 12005 Sunrise Valley Dr Ste 120, Reston, VA 20191-3469 | 2019-09-26 |
| 1477110765 | Laura Norman | Physician Assistant | 1860 Town Center Dr Ste 335, Reston, VA 20190-5900 | 2019-05-22 |
| 1245739895 | Carlee B. Genung | Physician Assistant | 1760 Reston Parkway Suite 306, Reston, VA 20190 | 2018-02-09 |
| 1902232747 | Samantha L Chang | Physician Assistant | 1850a Town Center Pkwy # 1, Suite 209, Reston, VA 20190-5851 | 2013-09-25 |
| 1982036786 | Stephanie Lourdes Miller | Physician Assistant | 12040 South Lakes Drive, Suite 207, Generations Family Practice, Reston, VA 20191 | 2013-08-02 |
| 1316295504 | Leigh Brewster Charron | Physician Assistant | 1800 Town Center Dr Ste 212, Reston, VA 20190-3238 | 2012-08-21 |
| 1902137193 | Amy Beckwith Rembold | Physician Assistant | 1800 Town Center Dr Ste 220, Reston, VA 20190-3238 | 2010-01-27 |
| 1184881583 | Christina M Barnett | Physician Assistant | 1860 Town Center Dr Ste 270, Reston, VA 20190-5899 | 2008-05-22 |
| 1760436620 | Lindsay D Orosz | Physician Assistant | 11800 Sunrise Valley Dr Ste 800, Reston, VA 20191 | 2006-05-22 |
| Find all providers in RESTON | ||||
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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.