KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. (NPI# 1710525803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710525803 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. |
| Practice Address |
14139 Potomac Mills Rd Woodbridge VA 22192-4644 |
| Practice Telephone | 7034908400 |
| Mailing Telephone | 7034908400 |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | MR. JOSEPH T BUTZ (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3018165867 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Woodbridge Medical Center DPP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316574833 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 4400 Forbes Blvd, Lanham, MD 20706-4447 | 2020-03-25 |
| 1215058326 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Health Maintenance Organization | 12255 Fair Oaks Pkwy, Fairfax, VA 22033-3952 | 2007-04-03 |
| 1285752121 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Health Maintenance Organization | 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 | 2007-03-27 |
| 1417075318 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Health Maintenance Organization | 7190 Crestwood Boulevard, Frederick, MD 21703-7314 | 2007-03-27 |
| 1699833202 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinical Medical Laboratory | 6625 Belcrest Highway, Hyattsville, MD 20782-2003 | 2006-12-05 |
| 1285272369 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 700 2nd St Ne, Washington, DC 20002-8100 | 2019-12-19 |
| 1457999542 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 4920 Campbell Blvd, Baltimore, MD 21236-5916 | 2019-12-19 |
| 1689212763 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 201 N Washington St, Falls Church, VA 22046-4518 | 2019-12-19 |
| 1659919744 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 6501 Loisdale Ct, Springfield, VA 22150-1826 | 2019-12-19 |
| 1447898531 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 7141 Security Blvd, Baltimore, MD 21244-1811 | 2019-12-19 |
| 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 |
14139 POTOMAC MILLS RD |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-4644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548268352 | Valencia J Cobb | Internal Medicine | 14139 Potomac Mills Rd, Kaiser Permanente Woodbridge Medical Center, Woodbridge, VA 22192-4644 | 2005-07-14 |
| 1437613866 | Anne M Kome | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2019-01-30 |
| 1265949093 | Amy Munsell Valenzuela | Registered Nurse | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2018-01-02 |
| 1154870145 | Yen Logan | Clinic/Center | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2016-10-01 |
| 1750838678 | Richard Alan Friedman | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2016-09-08 |
| 1679937130 | Ying Yin Chen | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2016-04-11 |
| 1730544297 | Fatima Qayum | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2015-12-28 |
| 1053785261 | Krystel Nasr | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2015-11-25 |
| 1780058206 | Daniel Huynh | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2015-11-20 |
| 1962876979 | Cynthia Adams | Pharmacist | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2015-11-16 |
| Find all providers in the same location | ||||
| 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 | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443359 | Henry A Mccleary Dc LLC | Clinic/Center | 2239c Tacketts Mill Dr, Woodbridge, VA 22192-3026 | 2020-03-26 |
| 1659788909 | Lifelong Good Health | Clinic/Center | 5721 Rhode Island Dr, Woodbridge, VA 22193 | 2014-07-18 |
| 1336480409 | Belinda Awuor Coleman | Clinic/Center | 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 | 2013-03-14 |
| 1851484935 | Prince William Health District Dental | Clinic/Center | 13792 Smoketown Rd, Woodbridge, VA 22192 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205437167 | Asoufy Therapy Services, Pllc | Clinic/Center | 916 Saint Andrews Reach Apt A, Chesapeake, VA 23320-8587 | 2020-11-05 |
| 1710594932 | Healthy Advocate | Clinic/Center | 5904 Carrington Green Ct, Glen Allen, VA 23060-3439 | 2020-09-30 |
| 1518573864 | Yi's Acupuncture Clinic,inc. | Clinic/Center | 4216 Evergreen Ln Ste 112, Annandale, VA 22003-3253 | 2020-09-22 |
| 1770191660 | Treasure Health Inc | Clinic/Center | 6000 Stevenson Ave Ste F, Alexandria, VA 22304-3563 | 2020-07-17 |
| 1962044420 | Alice Tseng Od Optometrist Pllc | Clinic/Center | 6211 Leesburg Pike, Falls Church, VA 22044-2107 | 2019-10-16 |
| 1164080057 | Hao Health and Healing LLC | Clinic/Center | 12011 Lee Jackson Memorial Hwy Ste 320, Fairfax, VA 22033-3310 | 2019-06-05 |
| 1245897941 | Metropolitan Medical | Clinic/Center | 3046 Valley Ave Ste 100, Winchester, VA 22601-2679 | 2019-05-29 |
| 1942768692 | Medsquare LLC | Clinic/Center | 8575a Sudley Rd, Manassas, VA 20110-3811 | 2019-03-12 |
| 1770055410 | Caring Hearts Free Clinic of Patrick County | Clinic/Center | 835 Woodland Dr Ste 101, Stuart, VA 24171-1586 | 2018-12-19 |
| 1851863708 | Tu Family Clinic LLC | Clinic/Center | 2946 Sleepy Hollow Rd Ste B, Falls Church, VA 22044-2003 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
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.