DERRICK JOHN MATHIS


Address: 9827 Sudley Manor Dr, Manassas, VA 20109-6232
Phone: 7035307751

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 376G00000X Nursing Home Administrator 1706000192 VA Nursing Service Related Providers

Other Providers DERRICK MATHIS

NPI Name Taxonomy Address Enumeration
1093086688 Derrick Mathis Driver 1551 N 29th St, Suite 1, Philadelphia, PA 19121-3620 2012-01-13

Office Location

Street Address 9827 SUDLEY MANOR DR
City MANASSAS
State VA
Zip Code 20109-6232

Providers in the same zip code

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 Information

Taxonomy Code 376G00000X
Grouping Nursing Service Related Providers
Classification Nursing Home Administrator

Taxonomy Definition

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.

Providers in the same taxonomy and state

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

Competitor

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City MANASSAS
Zip Code 20109

Improve Information

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Dataset Information

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.

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