NPIMap

Organization Active NPI

Bristow Pediatrics

  • Pediatrics Physician
  • Bristow, VA
National Provider Identifier
1003178005
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101234434 Issued in VA
Legal business name
BRISTOW PEDIATRICS
Practice address
10492 Bristow Center Dr
Bristow, VA 20136-2202
Phone
(571) 379-4246
Fax
(540) 379-4276
NPI assigned
Jun 14, 2012
Last updated
Dec 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gail Lynn Dolan, M.D.NPI 1568554731
Title
Owner
Phone
(571) 379-4246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101234434 VA Primary

Addresses

Primary practice location

10492 Bristow Center Dr
Bristow, VA 20136-2202

Mailing address

10492 Bristow Center Dr
Bristow, VA 20136-2202
Phone (571) 379-4246

National Provider Directory

National Provider Directory

Locations

10492 Bristow Center Dr
Bristow, VA 20136
Phone (571) 379-4246

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1003178005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10492 BRISTOW CENTER DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362202",
            "telephone_number": "571-379-4246",
            "fax_number": "571-379-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10492 BRISTOW CENTER DR",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201362202",
            "telephone_number": "571-379-4246",
            "fax_number": "540-379-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOW PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-379-4246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101234434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristow, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.