COUNTRYSIDE AMBULATORY SURG CENTER (NPI# 1073534012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073534012 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE AMBULATORY SURG CENTER |
| Practice Address |
44045 Riverside Pkwy Leesburg VA 20176-5101 |
| Mailing Address |
4 Pidgeon Hill Dr Sterling VA 20165-6101 |
| Practice Telephone | 7038586000 |
| Mailing Telephone | 7037377513 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN GRISH (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7038586604 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
OH 652 | VA | Ambulatory Health Care Facilities |
| Street Address |
44045 RIVERSIDE PKWY |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023016821 | Jennifer Gut | Nurse Anesthetist, Certified Registered | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2005-07-14 |
| 1376161885 | Alexis Lydia Doherty | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-07-10 |
| 1942821038 | Melissa Lynn Hwang | Registered Nurse | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-04-30 |
| 1366061574 | Commonwealth Emergency Physicians PC | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-04-09 |
| 1497387328 | Hannah Burzumato | Nurse Anesthetist, Certified Registered | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-08 |
| 1437781523 | Premier Trauma and Surgical Specialists LLC | Physician Assistant | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-07 |
| 1023640182 | Margaret Smith Lynch | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2020-02-06 |
| 1427694454 | Mary Christine Hogan | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2019-11-25 |
| 1669020442 | Brittany Marie Colley | Radiology | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2019-08-26 |
| 1457837395 | Susan Park Howell | Nurse Practitioner | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2018-07-13 |
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| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093344210 | Virginia Womens Center for Aesthetics | Clinic/Center | 19490 Sandridge Way Ste 360, Leesburg, VA 20176-3467 | 2020-04-08 |
| 1225281678 | Virginia Chiantella Md PC | Clinic/Center | 821 S King St Ste D, Leesburg, VA 20175-3914 | 2008-10-29 |
| 1598791105 | Total Eye Care Surgery Center Inc | Clinic/Center | 640 S Lake St, Leesburg, FL 34748-5927 | 2006-06-24 |
| 1669772943 | Cornwall Surgery Center | Clinic/Center | 224d Cornwall St Nw, Suite 300, Leesburg, VA 20176-2704 | 2010-11-02 |
| 1063442077 | Inova Loudoun Ambulatory Surgery | Clinic/Center | 44035 Riverside Pkwy, Suite 200, Leesburg, VA 20176-8260 | 2006-07-04 |
| 1235165531 | Lake Surgery & Endoscopy Center Ltd | Clinic/Center | 8110 County Road 44 Leg A, Leesburg, FL 34788-3704 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841815412 | Orthopaedic Surgery & Sports Med Specialist of Hampton Rds PC | Clinic/Center | 580 City Center Blvd, Newport News, VA 23606 | 2020-06-10 |
| 1306486634 | Fredericksburg Endoscopy Center, LLC | Clinic/Center | 1211 Central Park Blvd, Fredericksburg, VA 22401-4912 | 2020-01-15 |
| 1063058303 | Chesapeake Regional Surgery Center At Virginia Beach, LLC | Clinic/Center | 229 Clearfield Ave Ste 200, Virginia Beach, VA 23462-1815 | 2019-11-21 |
| 1154986347 | Center for Visual Surgical Excellence, LLC | Clinic/Center | 208 Carmichael Way, Chesapeake, VA 23322 | 2019-05-03 |
| 1720543481 | Surgical Suites of Coastal Virginia, LLC | Clinic/Center | 400 Sentara Cir Ste 200, Williamsburg, VA 23188-5716 | 2019-02-07 |
| 1962980045 | New Womens Health Charlottesville | Clinic/Center | 2050 Abbey Rd Ste D, Charlottesville, VA 22911-3553 | 2018-08-01 |
| 1518450790 | Virginia Ent Surgery Center Inc | Clinic/Center | 6600 W Broad St Ste 210, Richmond, VA 23230-1709 | 2018-06-12 |
| 1336649714 | Healthqare Services Asc LLC | Clinic/Center | 1005 N Glebe Rd Ste 200, Arlington, VA 22201-5792 | 2018-02-13 |
| 1104349489 | Valley Health Surgery Center, LLC | Clinic/Center | 174 Botanical Boulevard, Winchester, VA 22603 | 2017-07-19 |
| 1285169011 | Us Taxi Service LLC | Clinic/Center | 10824 Tutelo Ct, Glen Allen, VA 23059-8033 | 2017-04-30 |
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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.