RENEE BURDETT, MD PC (NPI# 1760540967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760540967 |
| Entity Type | Organization |
| Organization Name | RENEE BURDETT, MD PC |
| Practice Address |
13649 Office Place Suite 102 Woodbridge VA 22192 |
| Practice Telephone | 7036705738 |
| Practice Fax Number | 7036708213 |
| Mailing Telephone | 7036705738 |
| Mailing Fax Number | 7036708213 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-02-03 |
| Authorized Official Name | V RENEE BURDETT (MEDICAL DIRECTOR CEO) |
| Authorized Official Telephone | 7036705738 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Child & Family Counseling Center | Doing Business As Name - Organization |
| Child and Family Counseling Center | Doing Business As Name - Organization |
| Street Address |
13649 OFFICE PLACE SUITE 102 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821168212 | V Renee Burdett | Psychiatry & Neurology | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 1528138914 | James J Crist | Psychologist | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 1386714764 | Shawn P Emmons | Psychologist | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 1235209628 | Evelyn L Flynn | Social Worker | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 1578633962 | Betty O Graves | Social Worker | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 1497825889 | Jennifer L Edge | Social Worker | 13649 Office Place, Suite 102, Woodbridge, VA 22192 | 2006-11-09 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| 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.