MARY WASHINGTON HEALTHCARE PHYSICIANS (NPI# 1295999852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295999852 |
| Entity Type | Organization |
| Organization Name | MARY WASHINGTON HEALTHCARE PHYSICIANS |
| Practice Address |
2300 Fall Hill Ave Suite 512 Fredericksburg VA 22401-3342 |
| Mailing Address |
2300 Fall Hill Ave Suite 509 Fredericksburg VA 22401-3342 |
| Practice Telephone | 5407412423 |
| Practice Fax Number | 5407412458 |
| Mailing Telephone | 5407411821 |
| Mailing Fax Number | 5407411097 |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2017-07-24 |
| Authorized Official Name | DR. J MICHAEL MCDERMOTT (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 5407411414 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1295999852 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437713484 | Mary Washington Healthcare Physicians | Durable Medical Equipment & Medical Supplies | 4710 Spotsylvania Pkwy Ste 201, Fredericksburg, VA 22407-9433 | 2019-04-25 |
| 1063974830 | Mary Washington Healthcare Physicians | Durable Medical Equipment & Medical Supplies | 4710 Spotsylvania Pkwy Ste 101, Fredericksburg, VA 22407-9433 | 2019-04-02 |
| 1972167922 | Mary Washington Healthcare Physicians | Durable Medical Equipment & Medical Supplies | 2549 Cowan Blvd, Fredericksburg, VA 22401-8440 | 2019-04-25 |
| 1154883924 | Mary Washington Healthcare Physicians | Durable Medical Equipment & Medical Supplies | 3310 Fall Hill Ave, Fredericksburg, VA 22401-3000 | 2019-04-02 |
| 1770045544 | Mary Washington Healthcare Physicians | Durable Medical Equipment & Medical Supplies | 90 Greenspring Dr, Stafford, VA 22554-1752 | 2019-04-02 |
| 1518242361 | Mary Washington Healthcare Physicians | Neurological Surgery | 1101 Sam Perry Blvd, Suite 314, Fredericksburg, VA 22401-4467 | 2011-10-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Mary Washington Healthcare Physicians | 2300 Fall Hill Ave Ste 509, Fredericksburg, Virginia 22401-3343 |
| Street Address |
2300 FALL HILL AVE SUITE 512 |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-3342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115892 | Isabelle T Amann | Nurse Practitioner | 2300 Fall Hill Ave, Suite 234, Fredericksburg, VA 22401-3342 | 2005-09-27 |
| 1598188039 | Lorraine Hegi | Nurse Practitioner | 2300 Fall Hill Ave, Suite 515, Fredericksburg, VA 22401-3342 | 2014-02-03 |
| 1548601628 | Ann Michelle Jespersen | Specialist/Technologist | 2300 Fall Hill Ave, Suite 515, Fredericksburg, VA 22401-3342 | 2013-07-17 |
| 1578904637 | Abigail Godfrey | Speech-Language Pathologist | 2300 Fall Hill Ave, Suite 515, Fredericksburg, VA 22401-3342 | 2013-07-17 |
| 1407948953 | Sita S. Canady | Pediatrics | 2300 Fall Hill Ave, Suite 290 Fall Hill Pediatrics, Fredericksburg, VA 22401 | 2006-09-29 |
| 1619906286 | Fall Hill Pediatrics | Pediatrics | 2300 Fall Hill Ave, Suite 290, Fredericksburg, VA 22401-3342 | 2006-07-03 |
| 1053386730 | Elizabeth Miranda Koss | Physical Therapist | 2300 Fall Hill Ave, Suite 232, Fredericksburg, VA 22401-3342 | 2006-02-17 |
| 1609852052 | Jacinta Topps | Pediatrics | 2300 Fall Hill Ave, Suite 290, Fredericksburg, VA 22401-3342 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952573370 | Tedla T Tessema | Surgery | 1101 Sam Perry Blvd, Suite 219, Fredericksburg, VA 22401-4467 | 2008-03-26 |
| 1427241090 | Medidoctors LLC | Surgery | 1101 Sam Perry Blvd, Suite 314, Fredericksburg, VA 22401-4467 | 2007-08-27 |
| 1437102514 | Donald R Kauder | Surgery | 1101 Sam Perry Blvd, Suite 219, Fredericksburg, VA 22401-4467 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528685120 | Hannah Beam | Surgery | 1627 Farmington Dr, Forest, VA 24551-5612 | 2020-06-30 |
| 1023582046 | Lauren Elizabeth Rusy | Surgery | 111 Lighthouse Ln, Winchester, VA 22602-6191 | 2019-01-12 |
| 1548467855 | Timothy Joshua Donahue | Surgery | 2110 Marina Shores Dr # 330, Virginia Beach, VA 23451-6800 | 2007-06-29 |
| 1164495040 | Thomas Preston Davis | Surgery | 1148 Kingsbury Dr, Chesapeake, VA 23322-4264 | 2006-02-10 |
| 1417466780 | Hamdy Medical Center PC | Surgery | 110 Commonwealth Blvd W, Martinsville, VA 24112-1913 | 2017-09-29 |
| 1447796073 | Premier Trauma and Surgical Specialists LLC | Surgery | 44045 Riverside Pkwy, Leesburg, VA 20176-5101 | 2017-01-06 |
| 1902076169 | Paula E Ferrada | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2008-03-04 |
| 1144425034 | Rahul Jagdish Anand | Surgery | 1250 E Marshall St, Surgery, Richmond, VA 23298-5051 | 2007-06-19 |
| 1902993041 | Bryan Collier | Surgery | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2006-10-09 |
| 1700807179 | Christopher P Michetti | Surgery | 3300 Gallows Rd, Physician Billing, Falls Church, VA 22042-3307 | 2006-07-21 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
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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.