Kellyann Clark
INTENSIVE CARE CONSORTIUM INC


Address: 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Phone: 7036899000

Kellyann Clark (NPI# 1811249378, PAC ID# 8224288345) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1811249378
PAC ID by PECOS 8224288345
Professional Enrollment ID I20121105000265
Full Name Kellyann Clark
Organization Legal Name INTENSIVE CARE CONSORTIUM INC
Address 1850 Town Ctr Pkwy
Reston
VA 20190-3204
Phone Number 7036899000
Gender F
Graduation Year 2012
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 0244269413
Number of Group Practice Members 248
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
490107 RESTON HOSPITAL CENTER

Other Locations

Address Phone Organization
1701 N George Mason Dr, Arlington, VA 22205-3610 7035586161 EMERGENCY MEDICINE ASSOCIATES PA PC
1850 Town Ctr Pkwy, Reston, VA 20190-3204 7036899000 INTENSIVE CARE CONSORTIUM INC
1850 Town Ctr Pkwy, Reston, VA 20190-3219 7036899039 EMERGENCY MEDICINE ASSOCIATES PA PC

Organization Information

Organization Legal Name INTENSIVE CARE CONSORTIUM INC
Physicians 219

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Office Location

Street Address 1850 TOWN CTR PKWY
City RESTON
State VA
Zip 20190-3204

Physicians in the same location

Name Specialty Organization Address
Ardalan Enkeshafi Internal Medicine Emergency Medicine Associates Pa PC 1850 Town Ctr Pkwy, Reston, VA 20190-3219
Erik N Storm Certified Registered Nurse Anesthetist (crna) Reston Anesthesia Associates PC 1850 Town Ctr Pkwy, Reston, VA 20190-5205
Sarah K Jungnitsch Certified Registered Nurse Anesthetist (crna) Reston Anesthesia Associates PC 1850 Town Ctr Pkwy, Reston, VA 20190-5205
Andrew Harris Gordon Physical Medicine and Rehabilitation Post-acute Physicians of Virginia Pllc 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Barbara Pursell Certified Registered Nurse Anesthetist (crna) Reston Anesthesia Associates PC 1850 Town Ctr Pkwy, Reston, VA 20190-5205
Matthew H Griffith Orthopedic Surgery Arthritis and Sports Orthopaedics PC 1850 Town Ctr Pkwy, Reston, VA 20190-3219
John M Young Certified Registered Nurse Anesthetist (crna) Reston Anesthesia Associates PC 1850 Town Ctr Pkwy, Reston, VA 20190-5205
James W Cleveland Internal Medicine 1850 Town Ctr Pkwy, Suite 314, Reston, VA 20190-3219
Dennis Wang General Surgery Synergy Surgicalists Inc 1850 Town Ctr Pkwy, Suite 309, Reston, VA 20190-3219
Quang Hong Nguyen Interventional Radiology Reston Radiology Consultants, PC 1850 Town Ctr Pkwy, Reston, VA 20190-3219
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Physicians in the same zip code

Name Specialty Organization Address
Courtney E Hasseman Certified Nurse Midwife Specialty Physicians of Northern Virginia, LLC 1860 Town Ctr Dr, Suite 440, Reston, VA 20190
Dennis W Sager Internal Medicine 1800 Town Ctr Dr, Suite 313, Reston, VA 20190-3200
Christina M Barnett Physician Assistant Intensive Care Consortium Inc 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Melissa Guerra Physical Medicine and Rehabilitation Post-acute Physicians of Virginia Pllc 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Payam Pooyan Internal Medicine Intensive Care Consortium Inc 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Valerie Jones Physical Medicine and Rehabilitation Post-acute Physicians of Virginia Pllc 1850 Town Ctr Pkwy, Reston, VA 20190-3204
Juan A Trinidad General Practice 1800 Town Ctr Dr, Suite 310, Reston, VA 20190-3215
Donald G Hope Neurosurgery 1830 Town Ctr Dr, Suite 103, Reston, VA 20190-3216
Phoebe B Joseph Nurse Practitioner Privia Medical Group,llc 1830 Town Ctr Dr, Suite 103, Reston, VA 20190-3216
Alison Black Obstetrics/gynecology Privia Medical Group,llc 1830 Town Ctr Dr, Suite 103, Reston, VA 20190-3216
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Competitor

Search similar physicians

City RESTON
Zip Code 20190
Specialty NURSE PRACTITIONER
City + Specialty RESTON + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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