SETH LOUIS TOBACK (NPI# 1740289131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740289131 |
Entity Type | Individual |
Full Name | SETH LOUIS TOBACK |
Credential | MD |
Practice Address |
19450 Deerfield Avenue Suite 200 Leesburg VA 20176 |
Mailing Address |
4130 Parklake Ave Suite 400 Raleigh NC 27612-4461 |
Practice Telephone | 7037237337 |
Practice Fax Number | 7037236848 |
Mailing Telephone | 9197868318 |
Enumeration Date | 2005-07-18 |
Last Update Date | 2016-11-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | MD070587L | PA | Allopathic & Osteopathic Physicians |
Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
221122 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DEA | BT6675966 | 01 |
Street Address |
19450 DEERFIELD AVENUE SUITE 200 |
City | LEESBURG |
State | VA |
Zip Code | 20176 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316074768 | Senecca Elliott Kirkhart | Nurse Practitioner | 19450 Deerfield Avenue, Suite 200, Leesburg, VA 20176 | 2007-02-27 |
1124127253 | Tammy Dean Cayou | Nurse Practitioner | 19450 Deerfield Avenue, Suite 200, Leesburg, VA 20176 | 2006-09-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
Find all providers in zip 20176 |
Taxonomy Code | 2080A0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Adolescent Medicine |
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
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/certification - 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 |
---|---|---|---|---|
1528158045 | David Owen Elliott | Pediatrics | 1218 West Dixie Ave, B, Leesburg, FL 34748 | 2006-10-13 |
1184961898 | Maria M Mena Md | Pediatrics | 401 E North Blvd, Suite 101, Leesburg, FL 34748-5262 | 2013-01-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164869020 | Kyzwana N Caves | Pediatrics | 301 Riverview Ave Ste 3, Norfolk, VA 23510-1065 | 2013-05-31 |
1891814844 | East End Pediatrics, P.C. | Pediatrics | 4744 Finlay Street, Richmond, VA 23231 | 2007-03-29 |
1013042480 | Privia Medical Group, LLC | Pediatrics | 950 N Glebe Rd, Suite 4000, Arlington, VA 22203-1824 | 2007-02-23 |
1821133489 | John Stephen Zachary | Pediatrics | 1521 Huguenot Rd, Suite 101, Midlothian, VA 23113-2426 | 2007-02-21 |
1831246891 | William J. Mcaveney | Pediatrics | 221 Randolph St, Mineral, VA 23117-4493 | 2007-01-04 |
1619071149 | Irene Townsend | Pediatrics | 3605 Ferncliff Ave Nw, Roanoke, VA 24017-1411 | 2006-09-13 |
1447352018 | Richard Vichitr Chusuei | Pediatrics | 8373a Greensboro Dr, Mclean, VA 22102-3529 | 2006-09-02 |
1821105412 | Chang-kai Lilly Liu | Pediatrics | 8377a Greensboro Drive, Mclean, VA 22102-3529 | 2006-08-23 |
1356457774 | Patty Anne Chitwood | Pediatrics | Schiffert Health Center-virginia Tech, Nccomas Hall, Blacksburg, VA 24060 | 2006-08-21 |
1174637888 | Yasmin K. Anez | Pediatrics | 8365a Greensboro Dr, Mclean, VA 22102-3530 | 2006-08-18 |
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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.