LAKE RIDGE ANESTHESIA LLC (NPI# 1558619254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558619254 |
| Entity Type | Organization |
| Organization Name | LAKE RIDGE ANESTHESIA LLC |
| Practice Address |
12825 Minnieville Road # 220 Woodbridge VA 22192 |
| Mailing Address |
1302 Rising Ridge Rd # 1 Mount Airy MD 21771-5790 |
| Practice Telephone | 3018297386 |
| Practice Fax Number | 3018297694 |
| Mailing Telephone | 3018297683 |
| Mailing Fax Number | 3018297694 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | REZA IZADI (OWNER) |
| Authorized Official Telephone | 3018297683 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
0101237760 | VA | Allopathic & Osteopathic Physicians |
| Y | 207L00000X | Anesthesiology | 0101237760 | VA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Lake Ridge Anesthesia LLC | 2776 S Arlington Mill Drive, #121, Arlington, Virginia 22206 |
| Street Address |
12825 MINNIEVILLE ROAD # 220 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992724413 | Elethia V Wampler | Physical Therapist | 12825 Minnieville Road, Suite 203, Woodbridge, VA 22192-0045 | 2006-07-18 |
| 1972850808 | Lake Ridge Ambulatory Surgery Center, LLC | Clinic/Center | 12825 Minnieville Road, Suite 204, Woodbridge, VA 22192 | 2012-08-09 |
| 1194039511 | Greater Metropolitan Orthopaedic Institute | Internal Medicine | 12825 Minnieville Road, Suite 201/203, Woodbridge, VA 22192-0045 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427574581 | Pars Anesthesia Associates, Pllc | Anesthesiology | 2280 Opitz Blvd Ste 200, Woodbridge, VA 22191-3330 | 2017-08-20 |
| 1932243383 | John C Weinberg | Anesthesiology | 33 Forest Glen Dr, Woodbridge, CT 06525-1420 | 2007-02-19 |
| 1083100010 | Tranquil Anesthesia Group LLC | Anesthesiology | 14010 Smoketown Rd Ste 117, Woodbridge, VA 22192 | 2018-07-02 |
| 1386941250 | Sheridan Anesthesia Services of Virginia, Inc | Anesthesiology | 2280 Opitz Blvd, Woodbridge, VA 22191-3362 | 2011-02-11 |
| 1902109465 | Sheridan Anesthesia Services of Virginia, Inc | Anesthesiology | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2010-12-06 |
| 1629247580 | Long Hoang Trinh | Anesthesiology | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2008-02-25 |
| 1376747956 | Danny Walter Powell | Anesthesiology | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2007-06-14 |
| 1174605935 | Ali H. Nagia | Anesthesiology | 2280 Opitz Blvd, Suite 225, Woodbridge, VA 22191-3362 | 2006-10-20 |
| 1194820597 | Mohini T Gehani | Anesthesiology | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2006-09-13 |
| 1033214234 | Northern Virginia Anesthesia Assoc. | Anesthesiology | 2300 Opitz Blvd, Woodbridge, VA 22191-3311 | 2006-09-13 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
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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.