NPIMap

Organization Active NPI

Kid Koncepts,LLC

  • Early Intervention Provider Agency
  • Etlan, VA
National Provider Identifier
1013343110
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
0001092526 Issued in VA
Legal business name
KID KONCEPTS,LLC
Practice address
2861 S F T Valley Rd
Etlan, VA 22719-2000
Phone
(703) 346-7243
NPI assigned
Sep 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Authorized official

Name
Dr. Christine M Wallin, RN
Title
Developmental Consultant
Phone
(703) 346-7243

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 0001092526 VA Primary

Addresses

Primary practice location

2861 S F T Valley Rd
Etlan, VA 22719-2000

Mailing address

2861 S F T Valley Rd
Etlan, VA 22719-2000
Phone (703) 346-7243

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1013343110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 S F T VALLEY RD",
            "city": "ETLAN",
            "state": "VA",
            "postal_code": "227192000",
            "telephone_number": "703-346-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 S F T VALLEY RD",
            "city": "ETLAN",
            "state": "VA",
            "postal_code": "227192000",
            "telephone_number": "703-346-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID KONCEPTS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DEVELOPMENTAL CONSULTANT",
        "authorized_official_telephone_number": "703-346-7243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "VA",
            "license": "0001092526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Etlan, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.