Organization Active NPI

One Pediatrics PLLC

  • Pediatrics Physician
  • Ashburn, VA
National Provider Identifier
1104382985
Registry record updated Feb 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ONE PEDIATRICS PLLC
Practice address
20745 Williamsport PL Ste 340
Ashburn, VA 20147-6520
Phone
(917) 664-1143
NPI assigned
Feb 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2019

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

Authorized official

Name
Dr. Hind Bouallali, MDNPI 1427225788
Title
Owner
Phone
(917) 664-1143

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

20745 Williamsport PL Ste 340
Ashburn, VA 20147-6520

Mailing address

1135 Secretariat CT
Great Falls, VA 22066-1715
Phone (917) 664-1143

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2178624One Pediatrics PLLC20745 Williamsport PL Ste 340, Ashburn, VA 20147Certificate of waiverFeb 5, 2028

National Provider Directory

National Provider Directory

Locations

20745 Williamsport Pl
Ste 340
Ashburn, VA 20147
Phone (917) 664-1143

Practitioners & affiliated clinicians

Practitioners 2

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": "1550275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550275200000",
    "number": "1104382985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SECRETARIAT CT",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220661715",
            "telephone_number": "917-664-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20745 WILLIAMSPORT PL STE 340",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201476520",
            "telephone_number": "917-664-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-16",
        "last_updated": "2019-02-16",
        "status": "A",
        "authorized_official_last_name": "BOUALLALI",
        "authorized_official_first_name": "HIND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-664-1143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2019; 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.