NPIMap

Organization Active NPI

Stat Professional Services, LLC

Doing business as STAT Aesthetic Center

  • Registered Nurse
  • Woodbridge, VA
National Provider Identifier
1043088214
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
STAT PROFESSIONAL SERVICES, LLC
Doing business as
STAT Aesthetic Center
Practice address
14005 Crossing PL Ste 202
Woodbridge, VA 22192-4686
Phone
(703) 997-0967
Fax
(703) 997-0073
NPI assigned
Dec 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Nnenna Onwunmelu, RNNPI 1144908245
Title
Owner
Phone
(773) 997-0037

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

14005 Crossing PL Ste 202
Woodbridge, VA 22192-4686

Mailing address

15000 Potomac Town PL Ste 100-150
Woodbridge, VA 22191-6586
Phone (703) 997-0967

Other names 1

  • STAT Aesthetic Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stat Aesthetic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

15000 Potomac Town Pl
Ste 100150
Woodbridge, VA 22191

14005 Crossing Pl
Ste 202
Woodbridge, VA 22192
Phone (703) 997-0967

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1043088214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 POTOMAC TOWN PL STE 100-150",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221916586",
            "telephone_number": "703-997-0967",
            "fax_number": "703-997-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14005 CROSSING PL STE 202",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924686",
            "telephone_number": "703-997-0967",
            "fax_number": "703-997-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT PROFESSIONAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-16",
        "status": "A",
        "authorized_official_last_name": "ONWUNMELU",
        "authorized_official_first_name": "NNENNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-997-0037",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STAT Aesthetic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.