SUDLEY MEDICAL CLINIC INC (NPI# 1174829782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174829782 |
| Entity Type | Organization |
| Organization Name | SUDLEY MEDICAL CLINIC INC |
| Practice Address |
10757 Ambassador Dr Suite 101 Manassas VA 20109-2522 |
| Practice Telephone | 7036267501 |
| Practice Fax Number | 5713797468 |
| Mailing Telephone | 7036267501 |
| Mailing Fax Number | 5713797468 |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2012-09-28 |
| Authorized Official Name | MRS. MARIA E MENDOZA (OFFICE MANAGER) |
| Authorized Official Telephone | 7036267501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101239873 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
10757 AMBASSADOR DR SUITE 101 |
| City | MANASSAS |
| State | VA |
| Zip Code | 20109-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356685424 | Continental Home Health Care | Home Health | 10757 Ambassador Dr, Suite 201, Manassas, VA 20109-2522 | 2012-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151854 | Laura Zabel | Social Worker | 10220 Launch Circle #103, Manassas, VA 20109 | 2020-07-09 |
| 1659910677 | Leigh Cristi Babin-adkins | Registered Nurse | 10550 Linden Lake Plazza, Manassas, VA 20109 | 2019-12-23 |
| 1326686221 | Sophie Louise Elliot | Speech-Language Pathologist | 10550 Linden Lake Plaza Suite 100, Manassas, VA 20109 | 2019-12-11 |
| 1962978221 | Dominique Marie Cytryn | Behavior Technician | Family Insight, P.C., 7730 Donegan Dr, Manassas, VA 20109 | 2018-10-15 |
| 1255829008 | Lyusyena Teper | Physical Therapist | 11662 Sudley Manor Dr Ste 50-b, Manassas, VA 20109 | 2018-04-27 |
| 1861995060 | Mylisa L Ickes | Counselor | 7982 Donegan Drive, Manassas, VA 20109 | 2018-03-14 |
| 1336641885 | Stephanie Joanne Gamboa | Behavior Technician | 1037 Battleview Pkwy, Manassas, VA 20109 | 2018-03-01 |
| 1154822237 | Katherine Sholl | Behavior Technician | 10370 Battleview Parkway, Manassas, VA 20109 | 2018-02-23 |
| 1386168615 | Northern Virginia Checker Cab LLC | Taxi | 7631 Coppermine Dr, Manassas, VA 20109 | 2017-07-28 |
| 1407383201 | Monique Lowery | Social Worker | 7403 Emerald Dr., Manassas, VA 20109 | 2017-05-11 |
| Find all providers in zip 20109 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205350683 | Erin Kathleen Mckinney | Family Medicine | 8100 Ashton Ave Ste 101, Manassas, VA 20109-5647 | 2017-07-27 |
| 1679969406 | Verniese L Brown | Family Medicine | 8140 Ashton Ave Ste 125, Manassas, VA 20109-5700 | 2015-04-08 |
| 1740625557 | Kara E Siford | Family Medicine | 8640 Sudley Rd Ste 203, Manassas, VA 20110 | 2013-05-07 |
| 1972822344 | Patient First Richmond Medical Group Pllc | Family Medicine | 9715 Liberia Avenue, Manassas, VA 20110-5837 | 2010-05-25 |
| 1467640532 | Aime L Nuar | Family Medicine | 9213 Stonewall Rd, Manassas, VA 20110-2544 | 2007-10-13 |
| 1912022187 | Fairfax Family Prac Cen | Family Medicine | 8100 Ashton Avenue, Suite 101, Manassas, VA 20109 | 2007-03-20 |
| 1255427266 | John H Pace | Family Medicine | 8708 Sudley Rd, Manassas, VA 20110-4405 | 2006-10-05 |
| 1467550236 | Mohammed Haroon Azim | Family Medicine | 8694 Centreville Road, Manassas, VA 20110-5266 | 2006-09-20 |
| 1972607281 | Mohammed H. Azim M.d. and Ahmad Z. Qasimyar M.d. PC | Family Medicine | 8694 Centreville Rd, Manassas, VA 20110-5266 | 2006-09-08 |
| 1952416612 | Steven Richard Tucker | Family Medicine | 9001 Digges Rd Ste 206, Manassas, VA 20110-4414 | 2006-08-20 |
| Find all providers in MANASSAS | ||||
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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.