Pediatric Associates of Prince William County, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC ASSOCIATES OF PRINCE WILLIAM COUNTY, LLC

Practice address

9001 Digges Rd
Suite 107
Manassas, VA 20110-4421

Phone

(703) 368-9131

Fax

(703) 368-2038

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Adonia Johnson

Title

Director

Phone

(703) 368-9131

Specialties & licenses 1

Addresses

Other names 1

• PAPWC, LLC Other name

Locations

Practitioners 2

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

• Ethel M Henry, PA

  • Medical Physician Assistant
  • Manassas, VA
  • NPI 1942454269
  NPD (past)
• Louis Puppo, M.D.

  • Pediatrics Physician
  • Manassas, VA
  • NPI 1699802942
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1053592204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD",
            "address_2": "SUITE 107",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104421",
            "telephone_number": "703-368-9131",
            "fax_number": "703-368-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD",
            "address_2": "SUITE 107",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104421",
            "telephone_number": "703-368-9131",
            "fax_number": "703-368-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF PRINCE WILLIAM COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ADONIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-368-9131"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAPWC, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Philip R Peacock, DO
• Andrea T Peda, DVM
• Judith C Pederson, MD
• Pediatric Associates of Manassas
• Pediatric Associates of Northern Virginia, P.C.
• Pediatric Practice,PC
• Pediatricare of Northern Virginia, P.C.
• Pediatrix Medical Group PC
• Kevin Edward Peltier I, MD
• Nicole Penke, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.