Active NPI
Gina Cheri Pervall, MD
- Internal Medicine Physician
- Washington, DC
National Provider Identifier
1053433367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20302
- Practice address
- 616 H St NW
Lower Level
Washington, DC 20001-5800 - Phone
- (202) 636-7153
- Fax
- (202) 636-7180
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20302 | DC | Primary |
| Internal Medicine Physician | 207R00000X | D48015 | MD |
Addresses
Primary practice location
616 H St NW
Lower Level
Washington, DC 20001-5800
Mailing address
2903 Saint Regis Way
Mitchellville, MD 20721-2595
Phone (301) 390-8799
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D48015 | Other | MD | LICENSE |
| 20302 | Other | DC | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20302 | DC | MD | Internal Medicine Physician |
| D48015 | MD | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280188800000",
"number": "1053433367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2903 SAINT REGIS WAY",
"city": "MITCHELLVILLE",
"state": "MD",
"postal_code": "207212595",
"telephone_number": "301-390-8799",
"fax_number": "301-218-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 H ST NW",
"address_2": "LOWER LEVEL",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200015800",
"telephone_number": "202-636-7153",
"fax_number": "202-636-7180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERVALL",
"first_name": "GINA",
"middle_name": "CHERI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2010-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DC",
"license": "20302",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D48015",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "D48015",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "20302",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.