KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC. (NPI# 1578120747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578120747 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC. |
| Practice Address |
15050 Heathcote Blvd Haymarket VA 20169-6251 |
| Mailing Address |
22370 Davis Dr Sterling VA 20164-5367 |
| Practice Telephone | 5714557300 |
| Practice Fax Number | 5714557301 |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | JOSEPH T BUTZ (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3018165867 |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Kaiser Permanente Haymarket Crossroads Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298149 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Clinical Medical Laboratory | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-07-30 |
| 1164076915 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Health Maintenance Organization | 125 Hospital Center Blvd Ste 110, Stafford, VA 22554-6202 | 2019-07-30 |
| 1063066819 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Health Maintenance Organization | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-07-30 |
| 1760036511 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Clinical Medical Laboratory | 125 Hospital Center Blvd Ste 110, Stafford, VA 22554-6202 | 2019-07-30 |
| 1376004457 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Clinical Medical Laboratory | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2019-03-29 |
| 1134680200 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Health Maintenance Organization | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2019-03-29 |
| 1104128925 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Health Maintenance Organization | 1396 Piccard Dr, Rockville, MD 20850-4302 | 2010-11-30 |
| 1407157597 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Clinic/Center | 6104 Old Branch Ave, Temple Hills, MD 20748-2518 | 2010-11-05 |
| Street Address |
15050 HEATHCOTE BLVD |
| City | HAYMARKET |
| State | VA |
| Zip Code | 20169-6251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298149 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Clinical Medical Laboratory | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-07-30 |
| 1063066819 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Health Maintenance Organization | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831608025 | Renu Kaur | Social Worker | 15709 Foleys Mill Place, Haymarket, VA 20169 | 2017-09-20 |
| 1760928188 | Meae Nam | Home Health Aide | 6429 Ashby Grove Loop, Haymarket, VA 20169 | 2017-01-09 |
| 1497177406 | Candy Faviola Suarez | Physician Assistant | 15195 Heathcote Blvd Ste 230, Haymarket, VA 20169 | 2014-01-09 |
| 1649617101 | Nicholas Dugan | Surgery | 15195 Heathcote Blvd Ste 330, Haymarket, VA 20169 | 2013-05-23 |
| 1336497049 | Wal-mart Stores East Lp | Technician/Technologist | 6530 Trading Square, Haymarket, VA 20169 | 2012-08-28 |
| 1750637641 | Hema R Gajula | Psychiatry & Neurology | 15195 Heathcote Blvd Ste 350, Haymarket, VA 20169 | 2012-07-27 |
| 1689950396 | Meskerem Getachew | Pharmacist | 15610 Admiral Baker Circle, Haymarket, VA 20169 | 2011-10-26 |
| 1770861213 | Jenna Siracuse Loewer | Physical Therapist | 5401 Merchants View Sq, Haymarket, VA 20169 | 2011-08-02 |
| 1669767679 | Jeff Moon | Dentist | 6735 Leaberry Way, Haymarket, VA 20169 | 2011-06-17 |
| 1710159272 | David Wen | Psychologist | 6611 Jefferson St Ste 304, Haymarket, VA 20169 | 2008-03-25 |
| Find all providers in zip 20169 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016368 | Kaiser Foundation Health Plan of The Mid-atlantic States Inc. | Pharmacy | 125 Hospital Center Blvd Ste 110, Stafford, VA 22554-6202 | 2019-04-09 |
| 1073953873 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2013-06-26 |
| 1457416000 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1890 Metro Center Drive, Reston, VA 20190-5276 | 2006-12-26 |
| 1871067207 | Kaiser Foundation Healh Plan of The Mid-atlantic States Inc. | Pharmacy | 3000 Potomac Ave, Alexandria, VA 22305-3084 | 2019-01-18 |
| 1538429873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-05-21 |
| 1700159035 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1811031743 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6988 | 2007-02-16 |
| 1740340983 | Kaiser Permanente Ashburn Med Ctr | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6984 | 2006-12-11 |
| 1770643637 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 14139 Potomac Mills Road, Woodbridge, VA 22192 | 2006-12-11 |
| 1801954383 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 201 North Washington Street, Falls Church, VA 22046-4518 | 2006-12-05 |
| Find all providers with the same taxonomy | ||||
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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.