POTOMAC INOVA HEALTHCARE ALLIANCE, LLC (NPI# 1710151402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710151402 |
| Entity Type | Organization |
| Organization Name | POTOMAC INOVA HEALTHCARE ALLIANCE, LLC |
| Other Organization Name | WOODBRIDGE CT |
| Practice Address |
4001 Prince William Pkwy Woodbridge VA 22192-7630 |
| Mailing Address |
2990 Telestar Ct Suite 3pi Falls Church VA 22042-1207 |
| Practice Telephone | 7034943309 |
| Practice Fax Number | 7033579636 |
| Mailing Telephone | 5714235727 |
| Mailing Fax Number | 5714235702 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2010-11-23 |
| Authorized Official Name | COLLEEN HUELSKAMP (PROJECT MANAGER) |
| Authorized Official Telephone | 7032046371 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 344745 | 01 |
| Other Name | Type Code |
|---|---|
| Woodbridge CT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962676593 | Potomac Inova Healthcare Alliance, LLC | Clinic/Center | 2296 Opitz Blvd, Suite 140, Woodbridge, VA 22191-3300 | 2008-04-15 |
| Street Address |
4001 PRINCE WILLIAM PKWY |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-7630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346337979 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 4001 Prince William Pkwy, Suite 101, Woodbridge, VA 22192-7666 | 2006-10-06 |
| 1881016632 | P.w. Pediatrics P.C. | Public Health or Welfare | 4001 Prince William Pkwy, Suite 200, Woodbridge, VA 22192-7666 | 2014-01-14 |
| 1356507412 | Aar Woodbridge Imaging Center | Radiology | 4001 Prince William Pkwy, Suite 302, Woodbridge, VA 22192-7630 | 2008-07-29 |
| 1386733251 | Duong Trung Nguyen | Pediatrics | 4001 Prince William Pkwy, Suite 101, Woodbridge, VA 22192-7666 | 2006-10-11 |
| 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 | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255300471 | Insight Health Corp | Clinic/Center | 4001 Prince William Parkway, Suite 104, Woodbridge, VA 22192 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346898897 | Viva Richmond LLC | Clinic/Center | 6600 W Broad St Ste 200b, Richmond, VA 23230-1709 | 2019-08-28 |
| 1699328500 | Fairfax Radiological Consultants PC | Clinic/Center | 8260 Willow Oaks Corporate Dr Ste 200, Fairfax, VA 22031-4515 | 2019-07-19 |
| 1215438544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100a, Richmond, VA 23233 | 2018-02-22 |
| 1447538558 | Medarva Imaging | Clinic/Center | 1630 Wilkes Ridge Pkwy Ste 100, Richmond, VA 23233-7460 | 2011-07-25 |
| 1982995296 | Grafton Ct Imaging LLC | Clinic/Center | 4030 George Washington Mem Hwy Ste A, Grafton, VA 23692-2619 | 2011-04-21 |
| 1447555115 | Bon Secours-virginia Healthsource, Inc. | Clinic/Center | 7110 Forest Ave Ste 100, Richmond, VA 23226-3762 | 2011-01-11 |
| 1356646004 | Bon Secours-virginia Healthsource, Inc. | Clinic/Center | 11525 Midlothian Tpke Ste 103, Richmond, VA 23235-4763 | 2011-01-11 |
| 1255586277 | Bon Secours - Richmond Community Hospital, Incorporated | Clinic/Center | 4630 S. Laburnum Ave., Suite C, Richmond, VA 23231 | 2008-11-18 |
| 1811193899 | Medical Imaging of Fredericksburg, LLC | Clinic/Center | 125 Woodstream Boulevard, Suite 109, Stafford, VA 22556 | 2007-06-26 |
| 1801946090 | Patient First Ct, LLC | Clinic/Center | 8247 Meadowbridge Rd, Mechanicsville, VA 23116-2329 | 2007-01-11 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on POTOMAC INOVA HEALTHCARE ALLIANCE, LLC.
| 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.