The Pediatric Group, PC

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

Legal business name

THE PEDIATRIC GROUP, PC

Practice address

3914 Centreville Road
Chantilly, VA 20151

Phone

(703) 481-8600

NPI assigned

Apr 11, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Grader

Title

Administrator

Phone

(703) 971-6900

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

The Pediatric Group PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• The Pediatric Group, PC

  • Pediatrics Physician
  • Alexandria, VA
  • NPI 1710928437
  NPD tax ID
• The Pediatric Group, PC

  • Pediatric Registered Nurse
  • Lake Ridge, VA
  • NPI 1780808006
  NPD tax ID
• The Pediatric Group, PC

  • Pediatric Registered Nurse
  • Fairfax, VA
  • NPI 1851515175
  NPD tax ID
• The Pediatric Group, PC

  • Pediatric Adolescent Medicine Physician
  • Alexandria, VA
  • NPI 1922162205
  NPD tax ID

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023232345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 C MANCHESTER BLVD.",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 CENTREVILLE ROAD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20151",
            "telephone_number": "703-481-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRADER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-971-6900"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Taylor, RBT
• Keri Teboe
• Tselote Tesfaye
• Hien Amanda Thai
• The Bridge Counseling, PLLC
• The Virginia Endodontic Group
• The Virginia Institute PLLC
• Darby L Thoden, RBT
• Bianca Shane' Thompson, MSN, CNM
• Leanna Thompson

• Pediatric Registered Nurse in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Pediatric Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.