OLD DOMINION PATHOLOGY ASSOCIATES, LLC (NPI# 1134449051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134449051 |
| Entity Type | Organization |
| Organization Name | OLD DOMINION PATHOLOGY ASSOCIATES, LLC |
| Practice Address |
3289 Woodburn Rd Ste 220 Annandale VA 22003-6800 |
| Practice Telephone | 7036981080 |
| Practice Fax Number | 7036981082 |
| Mailing Telephone | 7036981080 |
| Mailing Fax Number | 7036981082 |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | BARRETT BOLTON BROWN (PARTNER) |
| Authorized Official Telephone | 7036911494 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Street Address |
3289 WOODBURN RD STE 220 |
| City | ANNANDALE |
| State | VA |
| Zip Code | 22003-6800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730156373 | John C Elkas | Obstetrics & Gynecology | 3289 Woodburn Rd, Suite 320, Annandale, VA 22003-6800 | 2006-03-02 |
| 1710349105 | Nazaneen Nassiry | Nurse Practitioner | 3289 Woodburn Rd, 200, Annandale, VA 22003-6800 | 2016-03-24 |
| 1114399466 | Ishmail Kamara | Nurse Practitioner | 3289 Woodburn Rd, Suite 200, Annandale, VA 22003-6800 | 2015-10-27 |
| 1407194186 | Center for Continence and Pelvic Support PC | Obstetrics & Gynecology | 3289 Woodburn Rd, Suite 130, Annandale, VA 22003-6800 | 2013-01-30 |
| 1073807996 | Aabha Jain | Internal Medicine | 3289 Woodburn Rd, Suite 200, Annandale, VA 22003-6800 | 2011-06-08 |
| 1255646311 | Apheresis Associates of Northern Virginia, LLC | Clinic/Center | 3289 Woodburn Rd, Suite 220, Annandale, VA 22003-6800 | 2010-08-13 |
| 1366755829 | Heather Blackstock Causseaux | Nurse Practitioner | 3289 Woodburn Rd, Suite 130, Annandale, VA 22003-6800 | 2010-07-26 |
| 1881925311 | Reconstructive Plastic Surgery Consultants, LLC | Plastic Surgery | 3289 Woodburn Rd, Suite 245, Annandale, VA 22003-6800 | 2010-01-22 |
| 1780824367 | Shalika Basnayake Katugaha | Internal Medicine | 3289 Woodburn Rd, Suite 200, Annandale, VA 22003-6800 | 2009-02-23 |
| 1932345931 | Mark Delman | Internal Medicine | 3289 Woodburn Rd, Suite 200, Annandale, VA 22003-6800 | 2008-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932741758 | Lien Hong Do | Pharmacist | 4014 Thornton Street, Annandale, VA 22003 | 2019-10-14 |
| 1639655376 | Brian D Blincoe | Military Health Care Provider | 7207 Masonville Drive, Annandale, VA 22003 | 2018-07-16 |
| 1790201481 | Mid Atlantic Plastic Surgeons LLC | Plastic Surgery | 3301 Woodburn Road, Suite 202, Annandale, VA 22003 | 2017-08-15 |
| 1053841668 | Rosalie Zuniga | Social Worker | 6800 Algonquin Court, Annandale, VA 22003 | 2017-06-15 |
| 1386179133 | Adaptive Care LLC | In Home Supportive Care | 4603 Logsdon Drive, Annandale, VA 22003 | 2017-04-28 |
| 1457808933 | Evergreen Foot and Ankle LLC | Podiatrist | 6928 Little River Turnpike, Suite B, Annandale, VA 22003 | 2016-09-01 |
| 1093165672 | Brightview Fairfax, LLC | Alzheimer Center (Dementia Center) | 3450 Gallows Road, Annandale, VA 22003 | 2016-06-15 |
| 1063867844 | Sports Care Acupuncture Clinic, LLC | Acupuncturist | 7535 Little River Tnpk #103a, Annandale, VA 22003 | 2016-04-28 |
| 1578925806 | Nu Dimensions, LLC | Day Training, Developmentally Disabled Services | 3602 Balin Ct, Annandale, VA 22003 | 2016-03-25 |
| 1932505641 | Julia Jiyoung Lee | Acupuncturist | 7535 Little River Tnpk, Suite 103a, Annandale, VA 22003 | 2014-11-06 |
| Find all providers in zip 22003 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710304761 | Sara Ali Mustafa | Pathology | 3289 Woodburn Rd Ste 220, Annandale, VA 22003-7313 | 2014-03-27 |
| 1114027604 | Bart J. Harmon | Pathology | 3800 Rose Ln, Annandale, VA 22003-1939 | 2006-09-24 |
| 1497755656 | Barrett Bolton Brown | Pathology | 3289 Woodburn Road, Suite #220, Annandale, VA 22003 | 2005-07-28 |
| 1225251192 | David Stanley Harrer | Pathology | 3299 Woodburn Rd, 210, Annandale, VA 22003-1275 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952821308 | Patricija Zot | Pathology | 1250 E Marshall St # 980662, Richmond, VA 23298-5051 | 2017-06-26 |
| 1508248949 | Rajeswari Jayakumar | Pathology | 403 N. 13th Street, Csc, Richmond, VA 23298 | 2015-06-22 |
| 1891192209 | Pepper Path LLC | Pathology | 45945 Trefoil Ln, Unit 175, Sterling, VA 20166-4343 | 2014-12-01 |
| 1477953578 | Jonathan Edwards | Pathology | Bon Secours Mary Immaculate Hospital, Pathology Dept, 2 Bernardine Dr, Newport News, VA 23602 | 2014-08-26 |
| 1629481700 | David Phillip Lebel II | Pathology | 1 Riverside Cir Ste 105, Roanoke, VA 24016-4961 | 2014-06-06 |
| 1215376959 | Angela Yu-jye Wu | Pathology | 1215 Lee Street - Box Number 800214, Charlottesville, VA 22908-0001 | 2013-06-16 |
| 1043529365 | Alden W Dudley Jr. | Pathology | 5909 Winnbrook Dr, Roanoke, VA 24018-7903 | 2010-10-04 |
| 1649582412 | Vasavi Kaliki | Pathology | 4505 Yorkminster Dr, Glen Allen, VA 23060-6157 | 2010-07-09 |
| 1063737146 | William F. Enos, M.d., Pllc | Pathology | 10300 Spotsylvania Avenue, Suite 130, Fredericksburg, VA 22408 | 2010-04-01 |
| 1992038749 | Gustavo Y. Vargas, M.d., Inc | Pathology | 3906 Bainbridge Blvd, Chesapeake, VA 23324-1610 | 2009-09-11 |
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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.