KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC (NPI# 1811031743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811031743 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC |
| Other Organization Name | ASHBURN MEDICAL CENTER PHARMACY |
| Practice Address |
43480 Yukon Dr Ste 100 Ashburn VA 20147-6988 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 7032275006 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2012-11-14 |
| Authorized Official Name | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165760 |
| 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 |
0201004121 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4839669 | 01 |
| Other Name | Type Code |
|---|---|
| Ashburn Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1710045299 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 655 Watkins Mill Road, Gaithersburg, MD 20879-3323 | 2006-12-05 |
| 1376601872 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Radiology | 10410 North Kensington Parkway, Kensington, MD 20895-2138 | 2006-12-05 |
| 1215002258 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 7141 Security Boulevard, Baltimore, MD 21244-1811 | 2006-11-22 |
| 1386183713 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2017-02-17 |
| 1366781700 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2013-02-05 |
| 1942546486 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2013-01-02 |
| 1104199421 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1245512110 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3323 | 2011-09-15 |
| Street Address |
43480 YUKON DR STE 100 |
| City | ASHBURN |
| State | VA |
| Zip Code | 20147-6988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861596447 | Roy Edward Park | Optometrist | 43480 Yukon Dr, Suite 214, Ashburn, VA 20147-6984 | 2006-09-12 |
| 1891036331 | Trudy Gambrel | Pharmacist | 43480 Yukon Dr, Kaiser Permanente Pharmacy, Ashburn, VA 20147-6988 | 2013-03-07 |
| 1023359965 | Minh N Ngo | Pharmacist | 43480 Yukon Dr, Suite 106, Ashburn, VA 20147-6988 | 2013-03-01 |
| 1316224876 | Naga Jyothi Vejalla | Pharmacist | 43480 Yukon Dr, Ashburn, VA 20147-6988 | 2011-11-12 |
| 1558512673 | Edwin J Lee Md PC | Otolaryngology | 43480 Yukon Dr, Suite 214, Ashburn, VA 20147-6988 | 2008-10-07 |
| 1700079373 | Estela Pena, Dds, LLC | Clinic/Center | 43480 Yukon Dr, Suite 204, Ashburn, VA 20147-6988 | 2007-08-27 |
| 1811198989 | Loudoun Eye Associates, Pllc | Optometrist | 43480 Yukon Dr, Suite 214, Ashburn, VA 20147-6984 | 2007-05-29 |
| 1699893537 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Health Maintenance Organization | 43480 Yukon Dr, Suite 100, Ashburn, VA 20147-6988 | 2007-03-27 |
| 1205985637 | Richard Kuang-hua Kao | Optometrist | 43480 Yukon Dr, Suite 214, Ashburn, VA 20147-6988 | 2007-01-08 |
| 1740340983 | Kaiser Permanente Ashburn Med Ctr | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6984 | 2006-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982039 | Smita J Patel | Pharmacist | 43614 Millay Ct., Ashburn, VA 20147 | 2020-11-04 |
| 1740812205 | Ericka N Schmitt | Psychologist | Interchange Psychology, 44075 Pipeline Plaza, Ashburn, VA 20147 | 2020-02-12 |
| 1164065967 | Dorsa Salehi | Behavior Technician | 44933 George Washing Blvd, Suite 115, Ashburn, VA 20147 | 2019-10-24 |
| 1659837094 | Sandrine Shanghai | Case Management | 44933 George Washington Parkway, Suite 110, Ashburn, VA 20147 | 2019-02-11 |
| 1033684154 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 44835 Russel Branch Parkway, Ashburn, VA 20147 | 2018-10-04 |
| 1417437203 | Roshni A Patel | Optometrist | 44050 Ashburn Village Blvd, Suite 163, Ashburn, VA 20147 | 2018-08-21 |
| 1972095974 | Verum Cutis Dermatology | Dermatology | 44110 Ashburn Shopping Plz Unit 237, Ashburn, VA 20147 | 2018-06-05 |
| 1033608542 | Justin Leeman | Physical Therapist | 21625 Red Rum Dr, Ashburn, VA 20147 | 2018-05-09 |
| 1255860680 | Aperiomics, Inc. | Clinical Medical Laboratory | 45085 University Dr, Ste 305, Ashburn, VA 20147 | 2017-06-08 |
| 1427591643 | Monecia Michelle Nelms | Counselor | 20925 Professional Plaza, Suite #320, Ashburn, VA 20147 | 2016-11-19 |
| Find all providers in zip 20147 | ||||
| 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 |
|---|---|---|---|---|
| 1740340983 | Kaiser Permanente Ashburn Med Ctr | Pharmacy | 43480 Yukon Dr, Ste 100, Ashburn, VA 20147-6984 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578120747 | Kaiser Foundation Health Plan of The Mid Atlantic States, Inc. | Pharmacy | 15050 Heathcote Blvd, Haymarket, VA 20169-6251 | 2019-05-23 |
| 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 |
| 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 |
| 1225196785 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 6501 Loisdale Road, Springfield, VA 22150-1885 | 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.