ETTIENNE'S PREMIER PEDIATRIC CARE LLC (NPI# 1841408697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841408697 |
| Entity Type | Organization |
| Organization Name | ETTIENNE'S PREMIER PEDIATRIC CARE LLC |
| Practice Address |
2905 Mitchellville Rd Ste 115 Bowie MD 20716-1385 |
| Practice Telephone | 3013907960 |
| Practice Fax Number | 3012182800 |
| Mailing Telephone | 3013907960 |
| Mailing Fax Number | 3012182800 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2013-12-12 |
| Authorized Official Name | SUZETTE SCIPIO ETTIENNE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3013907960 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | D0046373 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 363101000 | 05 |
| Street Address |
2905 MITCHELLVILLE RD STE 115 |
| City | BOWIE |
| State | MD |
| Zip Code | 20716-1385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801831540 | Janet Palmieri-parks | Social Worker | 2905 Mitchellville Rd, Suite 110, Bowie, MD 20716-1385 | 2006-06-17 |
| 1316551591 | Tomesha Jackson | Counselor | 2905 Mitchellville Rd, Bowie, MD 20716-1385 | 2020-09-03 |
| 1518468891 | Terri Williams | Massage Therapist | 2905 Mitchellville Rd, Bowie, MD 20716-1385 | 2018-02-22 |
| 1275075160 | Metro Area Chiropractic & Rehab | Chiropractor | 2905 Mitchellville Rd, Suite 116, Bowie, MD 20716-1385 | 2016-11-09 |
| 1417341017 | Solutions Life Coaching Services LLC | Social Worker | 2905 Mitchellville Rd, Suite 201, Bowie, MD 20716-1385 | 2015-03-23 |
| 1356749436 | Luz Francois | Counselor | 2905 Mitchellville Rd, Unit 201, Bowie, MD 20716-1385 | 2014-12-05 |
| 1760890008 | Crystal Ford | Counselor | 2905 Mitchellville Rd, 201, Bowie, MD 20716-1385 | 2014-07-31 |
| 1144518739 | Meena Somanchi | Nutritionist | 2905 Mitchellville Rd, 102, Bowie, MD 20716-1385 | 2011-07-16 |
| 1245527258 | In Step Podiatry Center, LLC | Durable Medical Equipment & Medical Supplies | 2905 Mitchellville Rd, Suite 105, Bowie, MD 20716-1385 | 2011-06-29 |
| 1295910792 | Primary Care Physicians LLC | Internal Medicine | 2905 Mitchellville Rd, Suite104, Bowie, MD 20716-1385 | 2008-01-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508330903 | Stacey Katheryn Lundquist | Counselor | 3060 Michellville Rd, Suite 106, Bowie, MD 20716 | 2019-01-18 |
| 1427528819 | Nicole Rudd | Counselor | 4315 Northview Dr, Bowie, MD 20716 | 2018-11-28 |
| 1427541838 | Outreach Recovery II, LLC | Internal Medicine | 4201 Northview Dr Ste 104, Bowie, MD 20716 | 2018-06-11 |
| 1487143608 | Fatimata Koroma | Counselor | 3953 Elite St, Bowie, MD 20716 | 2018-05-02 |
| 1043739618 | Breanna Collinson | Behavior Technician | 3017 New Oak Ln., Bowie, MD 20716 | 2017-09-15 |
| 1790202000 | Sierra Williams Howell | Nurse Practitioner | 2802 Eliston Street, Bowie, MD 20716 | 2017-08-28 |
| 1487175105 | Martine Jean | Technician | 15911 Pointer Ridge Rd, Bowie, MD 20716 | 2017-07-03 |
| 1902254493 | Olachi Enwerem | Licensed Practical Nurse | 16206 Audubon Lane, Bowie, MD 20716 | 2016-05-25 |
| 1780039230 | Debra Lachaune Garris | Specialist | 3042 Mitchiville Road, Bowie, MD 20716 | 2016-05-03 |
| 1750782553 | Medical Trasportation Systems LLC | Non-emergency Medical Transport (VAN) | 16036 Elegant Ave, Bowie, MD 20716 | 2014-09-11 |
| Find all providers in zip 20716 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457389892 | Jeannine Avis Clark | Pediatrics | 6915 Laurel Bowie Road, Suite 301, Bowie, MD 20715 | 2006-06-28 |
| 1275513053 | Valorie Anlage | Pediatrics | 17001 Science Drive, Suite 116, Bowie, MD 20715 | 2006-01-18 |
| 1144229667 | Toni Lynn Thompson-chittams | Pediatrics | 4357 Northview Dr, Bowie, MD 20716-2603 | 2005-07-18 |
| 1083610760 | Amina T Watson | Pediatrics | 1700 Science Drive, Suite 102, Bowie, MD 20715 | 2005-06-27 |
| 1285094094 | Love Kids LLC | Pediatrics | 14300 Gallant Fox Ln, 203, Bowie, MD 20715-4003 | 2016-03-07 |
| 1700266962 | Tlc Pediatrics | Pediatrics | 4357 Northview Dr, Bowie, MD 20716-2603 | 2015-06-03 |
| 1730252594 | Suzette Scipio - Ettienne | Pediatrics | 2905 Mitchellville Rd, Ste 115, Bowie, MD 20716-1385 | 2006-11-17 |
| 1770689416 | Azar Dashti | Pediatrics | 4379 Northview Dr, Bowie, MD 20716-2603 | 2006-09-16 |
| 1285648667 | Brenda Karen Pettus-bellamy | Pediatrics | 6915 Laurel Bowie Rd, Suite 301, Bowie, MD 20715 | 2006-07-28 |
| 1790786101 | Yvonne Marie Jackson | Pediatrics | 14300 Gallant Fox Ln, Suite 203, Bowie, MD 20715-4003 | 2005-08-09 |
| Find all providers in BOWIE | ||||
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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.