CENTREVILLE INTERNAL MEDICINE (NPI# 1073712352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073712352 |
| Entity Type | Organization |
| Organization Name | CENTREVILLE INTERNAL MEDICINE |
| Practice Address |
13880 Braddock Rd Ste 107 Centreville VA 20121-2460 |
| Practice Telephone | 7039650180 |
| Practice Fax Number | 7032669003 |
| Mailing Telephone | 7039650180 |
| Mailing Fax Number | 7032669003 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2012-08-09 |
| Authorized Official Name | SUGKEE YOUN (DIRECTOR) |
| Authorized Official Telephone | 7039650180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
0101235830 | VA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010419719 | 05 |
| Street Address |
13880 BRADDOCK RD STE 107 |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20121-2460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053498766 | Sugkee Youn | Internal Medicine | 13880 Braddock Rd Ste 107, Centreville, VA 20121-2460 | 2006-11-01 |
| 1912220112 | Sung Ryan Shin | Physician Assistant | 13880 Braddock Rd Ste 107, Centreville, VA 20121-2460 | 2010-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356906994 | Everyone Inc. | Durable Medical Equipment & Medical Supplies | 6362 James Harris Way, Centreville, VA 20121 | 2019-05-09 |
| 1154845139 | Dien Tu | Pharmacist | 6321 Powder Flask Ct., Centreville, VA 20121 | 2017-08-01 |
| 1053865337 | Chungkang Pharmacy, LLC | Pharmacy | 14637 Lee Highway, #109b, Centreville, VA 20121 | 2016-08-04 |
| 1265829808 | Trisha Yamamoto | Chiropractor | 14215 E. Centreville Square, Centreville, VA 20121 | 2015-04-21 |
| 1811305733 | Catherine Elizabeth Sims, LLC | Clinic/Center | 6705 Bay Valley Lane, Centreville, VA 20121 | 2014-07-23 |
| 1194138438 | All In A Day Senior Care Services.com | Home Health | 6913 Confederate Ridge Lane, Centerville, VA 20121 | 2014-06-04 |
| 1447519483 | James Hamilton | Occupational Therapy Assistant | 6220 William Mosby Dr, Centreville, VA 20121 | 2012-05-11 |
| 1609158674 | Rena Thuman | Dentist | 14245-f Centreville Square, Centreville, VA 20121 | 2011-09-15 |
| 1134426372 | One Stop Pharmacy Inc | Pharmacy | 13818-b Braddock Rd, Centreville, VA 20121 | 2011-02-24 |
| 1225267495 | Michael Andrew Hartman | Family Medicine | 6201 Centerville Rd, # 100, Centreville, VA 20121 | 2009-07-09 |
| Find all providers in zip 20121 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730535055 | Arirang Senior Community Services | Clinic/Center | 5649 Mount Gilead Rd, Centreville, VA 20120-1906 | 2016-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674199 | Brighter Prospective Residential Services, LLC | Clinic/Center | 2509 Tonoka Rd, Richmond, VA 23223-1739 | 2020-09-19 |
| 1396368288 | Tisha L Gholson | Clinic/Center | 4600 Winterbourne Dr, South Chesterfield, VA 23803-1727 | 2020-05-26 |
| 1457973588 | Ralpheana Denee Lawton | Clinic/Center | 2317 Richmond Ave, Portsmouth, VA 23704 | 2020-05-12 |
| 1861024317 | Semmes Ave Adult Daycare | Clinic/Center | 1500 Semmes Ave, Richmond, VA 23224-2072 | 2020-02-12 |
| 1033749445 | Vector Pathways LLC | Clinic/Center | 1300 Hopeman Pkwy, Waynesboro, VA 22980-1950 | 2020-01-24 |
| 1720618184 | Egbert Charles Mcfarlane | Clinic/Center | 1314 E Nine Mile Rd, Henrico, VA 23075-2306 | 2020-01-23 |
| 1205472586 | Oneda Care LLC | Clinic/Center | 5900 Brook Rd, Richmond, VA 23227-2258 | 2019-11-21 |
| 1760039010 | Christine Blair-wallace | Clinic/Center | 788 Bellwood Rd, Hampton, VA 23666-2806 | 2019-08-21 |
| 1801443403 | Cura Solutions LLC | Clinic/Center | 4312 Welford Ave, Richmond, VA 23234-2357 | 2019-08-20 |
| 1336793736 | Ebenezery Adult Day Services, LLC | Clinic/Center | 6321 Jahnke Rd, Richmond, VA 23225-4142 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 20121 |
Please comment or provide details below to improve the information on CENTREVILLE INTERNAL MEDICINE.
| 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.