Community Care Pediatrics, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024166627 Issued in VA

Legal business name

COMMUNITY CARE PEDIATRICS, LLC

Practice address

9444 Taney Rd
103
Manassas, VA 20110-5933

Phone

(703) 365-0227

Fax

(703) 365-0332

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Michelle Schmidt, CFNP

Title

Practitioner

Phone

(703) 365-0227

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1093096281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 FORESTWOOD LN",
            "address_2": "100",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104753",
            "telephone_number": "703-365-0227",
            "fax_number": "703-365-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9444 TANEY RD",
            "address_2": "103",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201105933",
            "telephone_number": "703-365-0227",
            "fax_number": "703-365-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "703-365-0227",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024166627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Manassas, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.