PATRONUS PHYSICIANS GROUP PC (NPI# 1851830178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851830178 |
| Entity Type | Organization |
| Organization Name | PATRONUS PHYSICIANS GROUP PC |
| Practice Address |
8000 Towers Crescent Dr Suite 1350 Vienna VA 22182-6207 |
| Practice Telephone | 8664501918 |
| Mailing Telephone | 8664501918 |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | CAREY GRAINGER (CEO) |
| Authorized Official Telephone | 4048224823 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Patronus Physicians Group PC | 5220 Jimmy Lee Smith Pkwy Pmb 265 Ste 104, Hiram, Georgia 30141-2853 |
| Street Address |
8000 TOWERS CRESCENT DR SUITE 1350 |
| City | VIENNA |
| State | VA |
| Zip Code | 22182-6207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902873185 | Leonard D Dasilva | Psychiatry & Neurology | 8000 Towers Crescent Dr, Ste 1350, Vienna, VA 22182-6207 | 2006-03-07 |
| 1457952681 | David Eduardo Lopez Cardona | Behavior Technician | 8000 Towers Crescent Dr, Vienna, VA 22182-6207 | 2020-11-04 |
| 1093316291 | Alexis Lacaille Lorick | Behavior Technician | 8000 Towers Crescent Dr, Vienna, VA 22182-6207 | 2020-11-04 |
| 1154921971 | Brianna Robinson | Behavior Technician | 8000 Towers Crescent Dr, Vienna, VA 22182-6207 | 2020-10-30 |
| 1710587522 | Amanda Clark | Behavior Technician | 8000 Towers Crescent Dr, Vienna, VA 22182-6207 | 2020-10-30 |
| 1013170067 | Michael J. Katsnelson | Psychiatry & Neurology | 8000 Towers Crescent Dr, Ste 1350, Vienna, VA 22182-6207 | 2008-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942775 | Khalina Boyce | Behavior Technician | 8000 Towers Crescent Drive, 13th Floor, Vienna, VA 22182 | 2020-11-03 |
| 1952963746 | Oula Kowatli | Dentist | 8255 Trailwood Ct, Vienna, VA 22182 | 2019-07-02 |
| 1326550989 | Acro Medical Group, LLC | Psychiatry & Neurology | 2106 Gallows Rd, Ste F, Vienna, VA 22182 | 2017-11-03 |
| 1063930816 | Hira Sarwar | Speech-Language Pathologist | 8229 Boone Blvd Suite 660, Vienna, VA 22182 | 2017-08-31 |
| 1205368388 | Visiting Angels | Point of Service | 2106-e Gallows Rd, Vienna, VA 22182 | 2017-03-29 |
| 1578923165 | Nina Sanjay Vani | Physical Therapist | 8320 Old Courthouse Rd Ste 401, Vienna, VA 22182 | 2016-02-25 |
| 1023489119 | Camille Eunice Abelardo | Physical Therapist | 8206 Leesburg Pike Ste 403, Vienna, VA 22182 | 2015-10-14 |
| 1770954075 | Meghan Macneil | Technician, Other | 2106 Gallows Road Suite E, Vienna, VA 22182 | 2015-10-13 |
| 1215306915 | Mauricio Colomo | Dentist | 8304-c Old Corthouse Rd, Tyson'scorner Dental Art Center, Vienna, VA 22182 | 2015-09-23 |
| 1992133037 | Pediatric Therapy Studio | Speech-Language Pathologist | 8227 Old - Courthouse Rd #115, Vienna, VA 22182 | 2013-10-29 |
| Find all providers in zip 22182 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639457591 | Raul Retana Garcia | General Practice | 601 Wolftrap Rd Se, Vienna, VA 22180-4944 | 2011-07-26 |
| 1316090178 | Faiz M Behsudi | General Practice | 1608 Spring Hill Road, Emergency Usa, Vienna, VA 22182 | 2007-01-18 |
| 1487839080 | Shannon R Ginnan | General Practice | 1934 Old Gallows Rd, Suite 500, Vienna, VA 22182-4042 | 2008-01-02 |
| 1699824375 | Faiz M. Behsudi, M.d. & Associates, P.C. | General Practice | 1608 Spring Hill Rd, Vienna, VA 22182-2241 | 2007-01-10 |
| 1073662532 | Emergency Usa, Inc. | General Practice | 1608 Spring Hill Rd, Vienna, VA 22182-2241 | 2007-01-10 |
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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.