BOULEVARD CENTER PEDIATRICS (NPI# 1568706158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568706158 |
| Entity Type | Organization |
| Organization Name | BOULEVARD CENTER PEDIATRICS |
| Practice Address |
3733 Fettler Park Dr. Dumfries VA 22025 |
| Practice Telephone | 7036700300 |
| Practice Fax Number | 7032915331 |
| Mailing Telephone | 7036700300 |
| Mailing Fax Number | 7032915331 |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | ANITA GOHEL (PRACTICE MANAGER) |
| Authorized Official Telephone | 7036700300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0101244499 | VA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Boulevard Center Pediatrics Inc. | 3733 Fettler Park Dr, Dumfries, Virginia 22025 |
| Street Address |
3733 FETTLER PARK DR. |
| City | DUMFRIES |
| State | VA |
| Zip Code | 22025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622230 | Joanne Perdu-ouimet | Behavioral Analyst | Incredible Changes, 4191 Waterway Dr., Dumfries, VA 22025 | 2020-09-04 |
| 1194287524 | Above and Beyond Therapy LLC | Speech-Language Pathologist | 15389 Autum Ln, Dumfries, VA 22025 | 2019-04-04 |
| 1669954095 | Renee L Roberts | Registered Nurse | 4222 Fortuna Center Plaza Ste 280, Dumfries, VA 22025 | 2018-09-01 |
| 1689044869 | Tracy Agyeman-badu | Pharmacist | 4310 Fortuna Village Center Plaza, Dumfries, VA 22025 | 2015-10-01 |
| 1588054316 | Tiffany Washington | Pharmacy Technician | 16224 Taconic Cir, Dumfries, VA 22025 | 2015-02-02 |
| 1205111796 | Khanh T Le | Pharmacist | 17506 Cajun Ct, Dumfries, VA 22025 | 2011-10-15 |
| 1679737761 | Shailesh K Gohel | Pediatrics | 3733 Fettler Park Dr, Dumfries, VA 22025 | 2008-07-17 |
| 1376616268 | Douglas Kendrick Chan | Physical Therapist | 3767 Fettler Park Drive, Dumfries, VA 22025 | 2006-11-16 |
| 1861596454 | Paul Wells Conrad | Dentist | 16150 Country Club Drive, Dumfries, VA 22025 | 2006-09-12 |
| 1518936244 | David Allen Pelfrey | Family Medicine | 3700 Fettler Park Drive, Dumfries Health Clinic, Dumfries, VA 22025 | 2006-03-15 |
| Find all providers in zip 22025 | ||||
| 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 |
|---|---|---|---|---|
| 1679737761 | Shailesh K Gohel | Pediatrics | 3733 Fettler Park Dr, Dumfries, VA 22025 | 2008-07-17 |
| 1760411631 | Indira Sinha | Pediatrics | 17618 Main St, Dumfries, VA 22026-2359 | 2006-07-02 |
| 1730450164 | Children First, Inc | Pediatrics | 17618 Main St, Dumfries, VA 22026-2359 | 2012-01-17 |
| 1619079308 | Patricia Anne Kearney | Pediatrics | 3700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 | 2006-09-02 |
| 1144261496 | Melissa Kari Gilmore | Pediatrics | 3700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 | 2006-06-09 |
| 1093785636 | Gracy Emmanuel Nidhiry | Pediatrics | 3700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 | 2006-01-25 |
| 1306816897 | Yuskiran Kaur Chhabra | Pediatrics | 3700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 | 2006-01-25 |
| 1598755977 | Sara Beth Levin | Pediatrics | 3700 Fettler Park, Dumfries Health Center, Dumfries, VA 22025 | 2005-10-26 |
| 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 |
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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.