MR. NICKOLAS PATRICK FORSBERG (NPI# 1073126215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073126215 |
| Entity Type | Individual |
| Full Name | MR. NICKOLAS PATRICK FORSBERG |
| Credential | PA-C |
| Practice Address |
11800 Sunrise Valley Dr Fl 8 Reston VA 20191-5300 |
| Practice Telephone | 7037091114 |
| Mailing Telephone | 7037091114 |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110007272 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11800 SUNRISE VALLEY DR FL 8 |
| City | RESTON |
| State | VA |
| Zip Code | 20191-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275150518 | Grace Andales Soistman | Nurse Practitioner | 11160 South Lakes Dr. Reston, Va 20191, Reston, VA 20191 | 2020-07-02 |
| 1790317709 | Twenty Four/7 LLC | Private Vehicle | 11922 Winterthur Ln, 103, Reston, VA 20191 | 2020-02-07 |
| 1437626058 | Aramesh Darvishian Dds Pllc | Dentist | 12040 South Lakes Dr. Suite 200, Reston, VA 20191 | 2018-11-01 |
| 1992282693 | Ashkan Ghods | Home Health | 11760 Sunrise Valley Dr, #405, Reston, VA 20191 | 2018-07-25 |
| 1104319698 | Capital Critical Care & Informatics PC | Internal Medicine | 11890 Sunrise Valley Dr # 442, Reston, VA 20191 | 2018-06-11 |
| 1063930683 | Mackenzie Marie Evans | Specialist/Technologist | 2380 Branleigh Park Ct, Reston, VA 20191 | 2017-09-04 |
| 1073910345 | Jane L Mahan-wiegand | Dietitian, Registered | 1900 Campus Commons Drive, Suite 100, Reston, VA 20191 | 2014-12-02 |
| 1700214293 | Sonny Sunghun Kim | Dentist | 11876 Sunrise Valley Drive, 101, Reston, VA 20191 | 2013-10-22 |
| 1982036786 | Stephanie Lourdes Miller | Physician Assistant | 12040 South Lakes Drive, Suite 207, Generations Family Practice, Reston, VA 20191 | 2013-08-02 |
| 1316250988 | Thao Ngoc Vuong | Pharmacist | 1898 Winterport Cluster, Reston, VA 20191 | 2010-07-23 |
| Find all providers in zip 20191 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1184680415 | Deborah Lee Nelson | Physician Assistant | 1860 Town Center Dr Ste 430, Reston, VA 20190 | 2006-04-25 |
| 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.