ERICKSON HEALTH MEDICAL GROUP OF VIRGINIA PC (NPI# 1871759340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871759340 |
| Entity Type | Organization |
| Organization Name | ERICKSON HEALTH MEDICAL GROUP OF VIRGINIA PC |
| Other Organization Name | ASHBY PONDS MEDICAL CENTER |
| Practice Address |
21170 Ashby Ponds Blvd Ashburn VA 20147 |
| Mailing Address |
5525 Research Park Dr Baltimore MD 21228-4664 |
| Practice Telephone | 5712916131 |
| Practice Fax Number | 5712916135 |
| Mailing Telephone | 5712916131 |
| Mailing Fax Number | 5712916135 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2015-04-21 |
| Authorized Official Name | DR. MATTHEW J NARRETT (SENIOR VP AND CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4104022257 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ashby Ponds Medical Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316098981 | Erickson Health Medical Group of Virginia PC | Durable Medical Equipment & Medical Supplies | 7440 Spring Village Dr, Springfield, VA 22150-4446 | 2007-01-12 |
| 1609896489 | Erickson Health Medical Group of Virginia PC | Family Medicine | 7440 Spring Village Dr, Springfield, VA 22150-4446 | 2006-07-21 |
| Street Address |
21170 ASHBY PONDS BLVD |
| City | ASHBURN |
| State | VA |
| Zip Code | 20147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326056045 | Thomas Francis Morris | Family Medicine | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2006-08-05 |
| 1043874837 | Brittany Lyn Smith | Physical Therapy Assistant | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2019-04-26 |
| 1386163475 | Dana Colvin | Nurse Practitioner | 21170 Ashby Ponds Blvd, Ashburn, VA 20147 | 2017-09-11 |
| 1477099489 | Ashby Ponds, Inc. | Clinic/Center | 21170 Ashby Ponds Blvd, Attn: Rehabilitation Manager, Ashburn, VA 20147-6128 | 2017-01-13 |
| 1710423306 | Ronald Longo | Social Worker | 21170 Ashby Ponds Blvd, Ashburn, VA 20147 | 2017-01-06 |
| 1326580267 | Aashee Gupta | Occupational Therapist | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2016-11-09 |
| 1992149470 | Karen Patton | Speech-Language Pathologist | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2013-04-26 |
| 1437497633 | Erickson Living Health Services, LLC | Clinic/Center | 21170 Ashby Ponds Blvd, Attn: Outpatient Administrator, Ashburn, VA 20147-6128 | 2013-01-22 |
| 1659618049 | Rebekah Hannay Jordan | Nurse Practitioner | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2013-01-07 |
| 1902119563 | Erickson Health Medical Group of Virginia, PC | Durable Medical Equipment & Medical Supplies | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2010-07-23 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386079788 | Prismamed Services LLC | Internal Medicine | 44790 Maynard Square, Suite 320, Ashburn, VA 20147 | 2013-09-05 |
| 1780029140 | Degha Fongod | Internal Medicine | 44121 Harry Byrd Hwy Ste 145, Ashburn, VA 20147-5667 | 2013-04-29 |
| 1336497213 | Jacek Krzepicki | Internal Medicine | 43568 Yorkshire Ct, Ashburn, VA 20147-4541 | 2012-08-27 |
| 1164650073 | Khizra Alam Khan | Internal Medicine | 43215 Somerset Hills Ter, Ashburn, VA 20147-5248 | 2009-06-30 |
| 1194973537 | Vandana Palagiri | Internal Medicine | 44790 Maynard Sq, Suite 320, Ashburn, VA 20147-6513 | 2008-08-27 |
| 1902072382 | Clyde Vernon Manning | Internal Medicine | 43025 Brookton Way, Ashburn, VA 20147-7414 | 2008-05-05 |
| 1841492733 | Shaveta Kotwal | Internal Medicine | 21170 Ashby Ponds Blvd., Ashburn, VA 20147 | 2007-06-03 |
| 1649484783 | Nagashree Gundu Rao | Internal Medicine | 21785 Filigree Ct Ste 203, Ashburn, VA 20147-6214 | 2007-05-09 |
| 1164643300 | Venkateswar R Veerapalli | Internal Medicine | 21001 Sycolin Rd Ste 180, Ashburn, VA 20147-4074 | 2007-05-02 |
| 1679697890 | Amelia Gail Lee | Internal Medicine | 21785 Filigree Ct Ste 100, Ashburn, VA 20147-6214 | 2007-03-16 |
| Find all providers in ASHBURN | ||||
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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.