KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC (NPI# 1770643637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770643637 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC |
| Other Organization Name | WOODBRIDGE MEDICAL CENTER PHARMACY |
| Practice Address |
14139 Potomac Mills Road Woodbridge VA 22192 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 7034907624 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-11-13 |
| Authorized Official Name | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165760 |
| 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 | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Woodbridge Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073953873 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2013-06-26 |
| 1457416000 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1890 Metro Center Drive, Reston, VA 20190-5276 | 2006-12-26 |
| 1710045299 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 655 Watkins Mill Road, Gaithersburg, MD 20879-3323 | 2006-12-05 |
| 1376601872 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Radiology | 10410 North Kensington Parkway, Kensington, MD 20895-2138 | 2006-12-05 |
| 1215002258 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 7141 Security Boulevard, Baltimore, MD 21244-1811 | 2006-11-22 |
| 1386183713 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2017-02-17 |
| 1366781700 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2013-02-05 |
| 1942546486 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2013-01-02 |
| 1104199421 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1245512110 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3323 | 2011-09-15 |
| Street Address |
14139 POTOMAC MILLS ROAD |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447224167 | Bethanne K Miller | Obstetrics & Gynecology | 14139 Potomac Mills Road, Kaiser Permanente Woodbridge Center, Woodbridge, VA 22192-4644 | 2006-02-17 |
| 1235496811 | Ebony Makeda Richards | Pediatrics | 14139 Potomac Mills Road, Pediatrics, Woodbridge, VA 22192 | 2012-04-19 |
| 1265577753 | Deepshikha Goyal | Pediatrics | 14139 Potomac Mills Road, Woodbridge, VA 22192 | 2007-02-21 |
| 1013062926 | Lisa A Pauls | Pediatrics | 14139 Potomac Mills Road, Woodbridge, VA 22192 | 2007-01-24 |
| 1689724437 | David Alan Dickey | Nurse Practitioner | 14139 Potomac Mills Road, Woodbridge, VA 22192-4644 | 2007-01-12 |
| 1033269790 | Herbert Norman Furst | Optometrist | 14139 Potomac Mills Road, Woodbridge, VA 20192-4644 | 2007-01-12 |
| 1962569996 | Stuart Q Hopkins | Internal Medicine | 14139 Potomac Mills Road, Woodbridge, VA 22192-4644 | 2007-01-02 |
| 1881759124 | Cynthia L Heins | Internal Medicine | 14139 Potomac Mills Road, Woodbridge, VA 22192-4644 | 2006-12-27 |
| 1295895746 | Clementina F Battad | Pediatrics | 14139 Potomac Mills Road, Woodbridge, VA 22192-4644 | 2006-12-12 |
| 1366503708 | Douglas Kiessling | Optometrist | 14139 Potomac Mills Road, Woodbridge, VA 20192-4644 | 2006-12-12 |
| 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 | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578120747 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Pharmacy | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-05-23 |
| 1477016368 | Kaiser Foundation Health Plan of The Mid-atlantic States Inc. | Pharmacy | 125 Hospital Center Blvd Ste 110, Stafford, VA 22554-6202 | 2019-04-09 |
| 1073953873 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2013-06-26 |
| 1457416000 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1890 Metro Center Drive, Reston, VA 20190-5276 | 2006-12-26 |
| 1871067207 | Kaiser Foundation Healh Plan of The Mid-atlantic States Inc. | Pharmacy | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2019-01-18 |
| 1538429873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-05-21 |
| 1700159035 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1811031743 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6988 | 2007-02-16 |
| 1740340983 | Kaiser Permanente Ashburn Med Ctr | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6984 | 2006-12-11 |
| 1801954383 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 201 North Washington Street, Falls Church, VA 22046-4518 | 2006-12-05 |
| 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.