PROVIDENCE HEALTH SERVICES, INC (NPI# 1730690801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730690801 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SERVICES, INC |
| Other Organization Name | PHS UNITY HEALTHCARE PARKSIDE RADIOLOGY |
| Practice Address |
765 Kenilworth Ter Ne Washington DC 20019-1898 |
| Mailing Address |
1150 Varnum St Ne St Catherines Hall, Room 102 Washington DC 20017-2104 |
| Practice Telephone | 2022991796 |
| Practice Fax Number | 2023888164 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |
| Authorized Official Name | BEAU HIGGINBOTHAN (VICE PRESIDENT/COO) |
| Authorized Official Telephone | 4103683162 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
HFD01-0212 | DC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PHS Unity Healthcare Parkside Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356859334 | Providence Health Services, Inc | Specialist | 1150 Varnum St Ne Ste 300, Washington, DC 20017-2180 | 2018-01-12 |
| 1609031632 | Providence Health Services, Inc | Psychiatry & Neurology | 1140 Varnum St Ne Ste 100, Washington, DC 20017 | 2008-07-18 |
| 1598313595 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-09-03 |
| 1740795293 | Providence Health Services, Inc | Nurse Anesthetist, Certified Registered | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-12-06 |
| 1679087365 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-11-17 |
| 1972012615 | Providence Health Services, Inc | Obstetrics & Gynecology | 1150 Varnum St Ne, St Catherine's Hall, 2nd Floor, Washington, DC 20017-2107 | 2017-09-26 |
| 1689005720 | Providence Health Services, Inc | General Acute Care Hospital | 1160 Varnum St Ne, Depaul 312, Washington, DC 20017-2107 | 2013-11-27 |
| 1366710766 | Providence Health Services, Inc | General Acute Care Hospital | 1140 Varnum St Ne, Pmb 200, Washington, DC 20017-2151 | 2011-12-13 |
| 1619245222 | Providence Health Services, Inc | Family Medicine | 128 M St Nw, Washington, DC 20001-1205 | 2011-12-09 |
| Street Address |
765 KENILWORTH TER NE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20019-1898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194813857 | Gebeyehu N Teferi | Internal Medicine | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2006-10-10 |
| 1033757604 | Julia Joyce | Registered Nurse | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2019-12-14 |
| 1275199572 | Richard John Elliott II | Student in an Organized Health Care Education/Training Program | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2019-05-13 |
| 1417440843 | Unity Health Care Inc | Pharmacy | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2018-06-11 |
| 1184157950 | Ayana Gallego | Dentist | 765 Kenilworth Ter Ne, Washington, DC 20019 | 2017-04-07 |
| 1982136842 | Danielle Fincher | Family Medicine | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2017-03-30 |
| 1780120774 | Unity Health Care Inc | Durable Medical Equipment & Medical Supplies | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2017-01-13 |
| 1417309949 | Tene Washington | Social Worker | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2016-07-08 |
| 1841654829 | Tiffany Garrett | Family Medicine | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2016-04-06 |
| 1114380474 | Nickia King | Family Medicine | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2016-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079440 | Gracefully Fulfilled Counseling and Coaching Services | Counselor | 219 56th Place Ne, Washington, DC 20019 | 2020-09-25 |
| 1033735170 | Regenia Elizabeth Sayles | Home Health Aide | 3924 Minnesota Ave Ne Washington, Dc, DC 20019 | 2020-06-24 |
| 1417578733 | Alycia Paige Heiner | Student in an Organized Health Care Education/Training Program | Parkside Health Center, 765 Kenilworth Terrace Ne, Washington, DC 20019 | 2020-04-27 |
| 1598398786 | Issa Munu | Technician | 45th Street Ne, 604, Washington, DC 20019 | 2020-02-17 |
| 1538708391 | Chanda Constance Mcmahan | Psychologist | 3320 Ames St. N.e., Washington, DC 20019 | 2019-12-27 |
| 1215582978 | Howard University | Clinic/Center | 4414-4430 Benning Road, Ne, Washington, DC 20019 | 2019-08-08 |
| 1255985776 | Kemba Kelton | Technician | 3204 1/2 East Capitol Street Nw, Washington, DC 20019 | 2019-08-01 |
| 1659930196 | Brittany Deshanta Fleming | Counselor | 1561 45th St Ne, Washington, DC 20019 | 2019-06-09 |
| 1346701299 | Chelsie Esek | Speech-Language Pathologist | 1234 Singleton Blvd., Washington Dc, DC 20019 | 2019-03-25 |
| 1174081434 | Kathleen Estelle Williams | Nurse's Aide | 12045th Street North East, 613, Washington, DC 20019 | 2019-03-06 |
| Find all providers in zip 20019 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598313595 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-09-03 |
| 1851476717 | Upmc and The Washington Hospital Cancer Center | Clinic/Center | 155 Wilson Ave, Washington, PA 15301-3336 | 2006-10-26 |
| 1942392667 | Metropolitan Radiology Associates Chartered | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017 | 2006-09-29 |
| 1518983139 | South Potomac Bone Assessment Center | Clinic/Center | 1328 Southern Ave Se, Suite 210, Washington, DC 20032-4689 | 2006-07-15 |
| City | WASHINGTON |
| Zip Code | 20019 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH SERVICES, 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.