KIMBERLY SOUTUYO (NPI# 1871998302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871998302 |
| Entity Type | Individual |
| Full Name | KIMBERLY SOUTUYO |
| Credential | NP |
| Practice Address |
2722 Merrilee Dr Suite 230 Fairfax VA 22031-4420 |
| Practice Telephone | 7036984444 |
| Practice Fax Number | 7032040116 |
| Mailing Telephone | 7036984444 |
| Mailing Fax Number | 7032040116 |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
0024172024 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2722 MERRILEE DR SUITE 230 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275523805 | Dana A Twible | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4400 | 2005-10-25 |
| 1437548005 | Varin Claire Bird | Physician Assistant | 2722 Merrilee Dr, Suite 230, Fairfax, VA 22031-4420 | 2015-01-20 |
| 1487091534 | Aaron Rich Ducoffe | Orthopaedic Surgery | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4400 | 2013-05-30 |
| 1871836312 | Kiet Trung Nguyen | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4400 | 2013-04-03 |
| 1528358199 | Daniel Macleod Fistere Jr. | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4400 | 2011-04-15 |
| 1538463724 | Faris Haddad | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4420 | 2011-01-02 |
| 1326364027 | Stephen V. Ho | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4400 | 2010-04-20 |
| 1538395827 | Marilyn Barry-brooks | Radiology | 2722 Merrilee Dr, Suite 230, Fairfax, VA 22031-4420 | 2009-06-01 |
| 1063650190 | Abraham Hyeon Jeon | Radiology | 2722 Merrilee Dr, Suite 230, Fairfax, VA 22031-4420 | 2009-01-27 |
| 1780836528 | Edward David Greenberg | Radiology | 2722 Merrilee Dr, Ste 230, Fairfax, VA 22031-4420 | 2008-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1033608989 | Liana Matevosian | Nurse Practitioner | 13104 Cross Keys Ct, Fairfax, VA 22033-1426 | 2018-05-07 |
| 1144674821 | Sonam Norbu | Nurse Practitioner | 4887 Wheatstone Dr, Fairfax, VA 22032-2341 | 2016-04-19 |
| 1992702617 | Mary Choisser Langford | Nurse Practitioner | 12011 Lee Jackson Hwy, Fairfax, VA 22033-3310 | 2005-07-07 |
| 1275179137 | Amelia Ellen Pitha | Nurse Practitioner | 8316 Arlington Blvd, Fairfax, VA 22031-5207 | 2019-11-25 |
| 1710530654 | Elizabeth Renshaw | Nurse Practitioner | 26136 Us Highway 59, Fairfax, MO 64446-9105 | 2019-07-19 |
| 1952650236 | Lisa Ann Sullivan | Nurse Practitioner | 3998 Fair Ridge Dr, Ste 320, Fairfax, VA 22033-2907 | 2012-09-03 |
| 1063768539 | Zahra Mohseni | Nurse Practitioner | 8503 Arlington Blvd Ste 200, Fairfax, VA 22031-4629 | 2012-08-02 |
| 1265615041 | Hillary M Morris | Nurse Practitioner | 8503 Arlington Blvd, Suite 200, Fairfax, VA 22031-4628 | 2007-12-14 |
| 1629164389 | Mary L Duggan | Nurse Practitioner | 3650 Joseph Siewick Dr, 400, Fairfax, VA 22033-1710 | 2006-10-04 |
| Find all providers in FAIRFAX | ||||
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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.