DERRICK JOHN MATHIS (NPI# 1780822841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780822841 |
Entity Type | Individual |
Full Name | DERRICK JOHN MATHIS |
Credential | ALFA |
Practice Address |
9827 Sudley Manor Dr Manassas VA 20109-6232 |
Practice Telephone | 7035307751 |
Mailing Telephone | 7035307751 |
Enumeration Date | 2009-01-28 |
Last Update Date | 2009-01-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 376G00000X | Nursing Home Administrator | 1706000192 | VA | Nursing Service Related Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093086688 | Derrick Mathis | Driver | 1551 N 29th St, Suite 1, Philadelphia, PA 19121-3620 | 2012-01-13 |
Street Address |
9827 SUDLEY MANOR DR |
City | MANASSAS |
State | VA |
Zip Code | 20109-6232 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275151854 | Laura Zabel | Social Worker | 10220 Launch Circle #103, Manassas, VA 20109 | 2020-07-09 |
1659910677 | Leigh Cristi Babin-adkins | Registered Nurse | 10550 Linden Lake Plazza, Manassas, VA 20109 | 2019-12-23 |
1326686221 | Sophie Louise Elliot | Speech-Language Pathologist | 10550 Linden Lake Plaza Suite 100, Manassas, VA 20109 | 2019-12-11 |
1962978221 | Dominique Marie Cytryn | Behavior Technician | Family Insight, P.C., 7730 Donegan Dr, Manassas, VA 20109 | 2018-10-15 |
1255829008 | Lyusyena Teper | Physical Therapist | 11662 Sudley Manor Dr Ste 50-b, Manassas, VA 20109 | 2018-04-27 |
1861995060 | Mylisa L Ickes | Counselor | 7982 Donegan Drive, Manassas, VA 20109 | 2018-03-14 |
1336641885 | Stephanie Joanne Gamboa | Behavior Technician | 1037 Battleview Pkwy, Manassas, VA 20109 | 2018-03-01 |
1154822237 | Katherine Sholl | Behavior Technician | 10370 Battleview Parkway, Manassas, VA 20109 | 2018-02-23 |
1386168615 | Northern Virginia Checker Cab LLC | Taxi | 7631 Coppermine Dr, Manassas, VA 20109 | 2017-07-28 |
1407383201 | Monique Lowery | Social Worker | 7403 Emerald Dr., Manassas, VA 20109 | 2017-05-11 |
Find all providers in zip 20109 |
Taxonomy Code | 376G00000X |
Grouping | Nursing Service Related Providers |
Classification | Nursing Home Administrator |
An individual, often licensed by the state, who is responsible for the management of a nursing home. |
Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL, 1994, p. 552. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750855847 | Madonna Home | Nursing Home Administrator | 814 W 37th St, Norfolk, VA 23508-2610 | 2019-01-11 |
1750743738 | Erica Muma | Nursing Home Administrator | 13293 Orangewood Dr, Woodbridge, VA 22193-3986 | 2016-03-28 |
1174934921 | Nita Davison | Nursing Home Administrator | 1050 Temple Ave, Suite 251, Colonial Heights, VA 23834-2981 | 2014-05-14 |
1871046557 | Surjit Singh | Nursing Home Administrator | 8989 Cotswold Dr, Burke, VA 22015-1655 | 2016-07-28 |
1083856629 | Marjorie Guerrero Cruz | Nursing Home Administrator | 6490 Wolf Run Shoals Rd, Fairfax Station, VA 22039-1742 | 2009-03-27 |
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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.