SHADY GROVE PEDIATRICS, PC (NPI# 1285064758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285064758 |
| Entity Type | Organization |
| Organization Name | SHADY GROVE PEDIATRICS, PC |
| Other Organization Name | KING GEORGE PEDIATRICS |
| Practice Address |
11127 Journal Pkwy King George VA 22485-3468 |
| Practice Telephone | 5407756891 |
| Practice Fax Number | 5407756894 |
| Mailing Telephone | 5407756891 |
| Mailing Fax Number | 5407756894 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |
| Authorized Official Name | ILYA ZAVELSKY (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 5407756891 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| King George Pediatrics | Doing Business As Name - Organization |
| Street Address |
11127 JOURNAL PKWY |
| City | KING GEORGE |
| State | VA |
| Zip Code | 22485-3468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336386309 | Ilya Zavelsky | Pediatrics | 11127 Journal Pkwy, Ste 101, King George, VA 22485-3468 | 2009-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528699675 | Philicia J King | Nurse Practitioner | 16463 Va-206, King George, VA 22485 | 2020-01-28 |
| 1811492994 | Jason J Wheeler | Psychologist | King George High School, 10100 Foxes Way, King George, VA 22485 | 2018-03-29 |
| 1649668690 | Access Eye Centers, PC | Optometrist | 7961 Kings Hwy., King George, VA 22485 | 2014-12-29 |
| 1568808277 | Alice Ann Pallotti | Massage Therapist | 9305 King's Hwy, Suite A, King George, VA 22485 | 2013-05-21 |
| 1679876296 | Virginia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 11458 Kings Highway, King George, VA 22485 | 2010-12-21 |
| 1962679506 | Kathleen Ann Fitzsimmons | Counselor | 5506 Payne Dr, King George, VA 22485 | 2008-05-13 |
| 1275574279 | Kristie F Mcdowell | Physician Assistant | 11131 Journal Parkway, King George, VA 22485 | 2006-06-09 |
| 1780675702 | King George Life Care, LLC | Skilled Nursing Facility | 10051 Foxes Way, Box 495, King George, VA 22485 | 2005-10-31 |
| 1881059624 | Jill Bain Wine | Speech-Language Pathologist | 5254 Potomac Dr Ste A, King George, VA 22485 | 2015-12-21 |
| 1245486802 | Roosevelt Dean Jr. | Family Medicine | 11131 Journal Parkway, King George, VA 22485 | 2008-08-14 |
| Find all providers in zip 22485 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013479682 | New Heights Pediatrics, LLC | Pediatrics | 8117 Kings Hwy, King George, VA 22485-7068 | 2019-04-03 |
| 1336386309 | Ilya Zavelsky | Pediatrics | 11127 Journal Pkwy, Ste 101, King George, VA 22485-3468 | 2009-01-13 |
| 1730267352 | Ayanna J Mccray | Pediatrics | 7967 Kings Hwy, King George, VA 22485-7075 | 2006-11-01 |
| 1942684097 | Sentara Medical Group | Pediatrics | 7967 Kings Hwy, King George, VA 22485-7075 | 2015-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183303 | Charles Eshel Stith IIi | Pediatrics | 317 Middle Oaks Dr, Chesapeake, VA 23322-7502 | 2020-11-01 |
| 1962002717 | Caylee Cook | Pediatrics | 9900 Independence Park Dr Ste 100, Richmond, VA 23233-1473 | 2020-10-30 |
| 1659978039 | Jessica N Johnson | Pediatrics | 4078 Country Club Rd, Brodnax, VA 23920-3404 | 2020-10-08 |
| 1053921627 | Acorn Pediatrics, Inc | Pediatrics | 2610-b Gaskins Road, Henrico, VA 23238 | 2020-08-07 |
| 1134738602 | Lolita Lopez | Pediatrics | 43547 Freeport Pl, Sterling, VA 20166-2160 | 2020-07-30 |
| 1184252330 | Arlene Marie Lorica | Pediatrics | 7902 Tysons One Pl Unit 2613, Mc Lean, VA 22102-5239 | 2020-03-31 |
| 1508493883 | Katie Marie Davis | Pediatrics | 5807 Fox Briar Way, Midlothian, VA 23112-6364 | 2020-03-25 |
| 1649817636 | Susan Jane Argyle | Pediatrics | 7501 Little River Tpke Ste 202, Annandale, VA 22003-2923 | 2019-12-09 |
| 1003477621 | Deborah Williams Ward | Pediatrics | 1810 Plain View Rd, Henrico, VA 23238-4152 | 2019-06-25 |
| 1467012120 | Keith Henry | Pediatrics | 23458 Cool Water Dr, Ruther Glen, VA 22546-3325 | 2019-06-15 |
| Find all providers with the same taxonomy | ||||
| City | KING GEORGE |
| Zip Code | 22485 |
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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.