PROVIDENCE HEALTH SERVICES, INC (NPI# 1356859334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356859334 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SERVICES, INC |
| Other Organization Name | PHS CARDIOLOGY |
| Practice Address |
1150 Varnum St Ne Ste 300 Washington DC 20017-2180 |
| Mailing Address |
1150 Varnum St Ne St Catherines Hall, Room 102 Washington DC 20017-2104 |
| Practice Telephone | 2028544830 |
| Practice Fax Number | 2028544836 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |
| Authorized Official Name | BEAU HIGGINBOTHAN (VICE PRESIDENT/COO) |
| Authorized Official Telephone | 4103683182 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | HFD01-0212 | DC | Other Service Providers |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
HFD01-0212 | DC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PHS Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609031632 | Providence Health Services, Inc | Psychiatry & Neurology | 1140 Varnum St Ne Ste 100, Washington, DC 20017 | 2008-07-18 |
| 1598313595 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-09-03 |
| 1740795293 | Providence Health Services, Inc | Nurse Anesthetist, Certified Registered | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-12-06 |
| 1679087365 | Providence Health Services, Inc | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2017-11-17 |
| 1730690801 | Providence Health Services, Inc | Clinic/Center | 765 Kenilworth Ter Ne, Washington, DC 20019-1898 | 2017-10-17 |
| 1972012615 | Providence Health Services, Inc | Obstetrics & Gynecology | 1150 Varnum St Ne, St Catherine's Hall, 2nd Floor, Washington, DC 20017-2107 | 2017-09-26 |
| 1689005720 | Providence Health Services, Inc | General Acute Care Hospital | 1160 Varnum St Ne, Depaul 312, Washington, DC 20017-2107 | 2013-11-27 |
| 1366710766 | Providence Health Services, Inc | General Acute Care Hospital | 1140 Varnum St Ne, Pmb 200, Washington, DC 20017-2151 | 2011-12-13 |
| 1619245222 | Providence Health Services, Inc | Family Medicine | 128 M St Nw, Washington, DC 20001-1205 | 2011-12-09 |
| Street Address |
1150 VARNUM ST NE STE 300 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20017-2180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588215479 | Janet Achankeng Folem | Psychologist | 7100 Varnum St Ne, Suit 218, Washington, DC 20017 | 2019-09-23 |
| 1013475284 | Raphaelia Agnes Johnson-phillips | Technician | 440 Taylor St. Ne Building B Apt 22, Washington Dc, DC 20017 | 2019-03-06 |
| 1528551413 | Harpreet Saluja | Student in an Organized Health Care Education/Training Program | 1150 Varnum St Ne, Providence Hospital Im Department, Washington, DC 20017 | 2018-06-14 |
| 1134638042 | Jane Hayashi-kim | Speech-Language Pathologist | 3910 9th St Ne, Apartment 3, Washington, DC 20017 | 2017-09-22 |
| 1346766102 | Aaliyah Gabrielle Jones | Technician | 611edgewood Ne, Washington, DC 20017 | 2017-08-14 |
| 1417479197 | Javalin Singh | Home Health Aide | Hsc Pediatric Center 1731 Bunker Hill Rd, Washington, DC 20017 | 2017-07-13 |
| 1386174175 | Genevieve Wells | Home Health Aide | 601 Edgewood St. Ne, Apt 706, Washington, DC 20017 | 2017-06-14 |
| 1487183810 | Valerie Anne Pierre | Student in an Organized Health Care Education/Training Program | 1150 Varnum Street, N.e., Acc 209, Washington, DC 20017 | 2017-06-08 |
| 1639600984 | Liliana Tatum | Counselor | 1428 Hamlin Street Ne, Washington, DC 20017 | 2017-03-27 |
| 1750835435 | Marie Hortense Mabou Sando | Home Health Aide | 1416 9th Street Nwdc, Washington, DC 20017 | 2016-08-10 |
| Find all providers in zip 20017 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346805322 | Jaffar Mohammad Khan | Internal Medicine | 110 Irving St Nw Rm 4b1, Washington, DC 20010-3017 | 2019-05-06 |
| 1922449339 | Ankit Mahajan | Internal Medicine | 850 Quincy St Nw, Apt- 509, Washington, DC 20011-5867 | 2013-07-13 |
| 1720373137 | Harjit K Chahal | Internal Medicine | 1133 21st Street Nw, Suite 700, Washington, DC 20036 | 2011-06-14 |
| 1437325883 | Gurusher Singh Panjrath | Internal Medicine | 2150 Pennsylvania Avenue, Suite 4407, Washington, DC 10467-2510 | 2008-05-06 |
| 1801069679 | Roquell E. Wyche | Internal Medicine | 1015 I St Ne, Washington, DC 20002-3747 | 2008-04-11 |
| 1427268424 | Joseph A Quash Jr. | Internal Medicine | 1160 Varnum St Ne #100, Washington, DC 20017 | 2007-05-22 |
| 1891811501 | All Heart Medical Center | Internal Medicine | 1647 Benning Rd, #201, Washington, DC 20002 | 2007-03-22 |
| 1821125576 | Jerry Allison Snow | Internal Medicine | 4900 Massachusetts Avenue Nw, Suite 300, Washington, DC 20016-4358 | 2007-02-28 |
| 1184760662 | Jose Vargas | Internal Medicine | 3800 Reservoir Rd Nw # 5phc, Washington, DC 20007-2113 | 2007-01-30 |
| 1205989068 | Farooq Hameed Sheikh | Internal Medicine | 110 Irving St Nw Ste 1e12, Washington, DC 20010-3017 | 2007-01-18 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20017 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH SERVICES, INC.
| 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.