Casa Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

CASA PEDIATRICS

Practice address

14130 Noblewood PLZ
Suite 306
Woodbridge, VA 22193-1464

Phone

(703) 485-0470

Fax

(703) 986-0825

NPI assigned

Aug 28, 2014

Last updated

Aug 29, 2014By 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

Dr. Martha Lissett Casamalhuapa Calderon, M.D.

Title

Ceo / Medical Director

Phone

(703) 485-0470

Specialties & licenses 2

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

Locations

Practitioners 6

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.

• Allison Callow, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Woodbridge, VA
  • NPI 1134912272
  NPD (past)
• Martha Lissett Casamalhuapa, M.D.

  • Pediatrics Physician
  • Woodbridge, VA
  • NPI 1912288515
  NPD (past)
• Janique Lartey

  • Family Nurse Practitioner
  • Woodbridge, VA
  • NPI 1609724095
  NPD (past)
• Clayton G Powell, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1235083270
  NPD (past)
• Krista Reid, PA-C

  • Physician Assistant
  • Fairfax, VA
  • NPI 1740086958
  NPD (past)
• Jolie Rivenbark, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1831835800
  NPD (past)

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1033519855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14130 NOBLEWOOD PLZ",
            "address_2": "SUITE 306",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931464",
            "telephone_number": "703-485-0470",
            "fax_number": "703-986-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 NOBLEWOOD PLZ",
            "address_2": "SUITE 306",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931464",
            "telephone_number": "703-485-0470",
            "fax_number": "703-986-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "CASAMALHUAPA CALDERON",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "LISSETT",
        "authorized_official_title_or_position": "CEO / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "703-485-0470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Carter, LPC-R
• Zena R Carter, MPH, MSHS, PA-C
• Isabella Theresa Carunungan
• Monica Sue Carver, NP
• Casa Pediatric Urgent Care
• Casa Wellness
• Martha Lissett Casamalhuapa, M.D.
• Carlyle Fairfax Hooff Casella, PA
• Casim LLC
• Sara A Castellano, BCBA

• Pediatrics Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.