Milestones Pediatric and Adolescent Care, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101239493 Issued in VA

Legal business name

MILESTONES PEDIATRIC AND ADOLESCENT CARE, LLC

Practice address

7500 Iron Bar LN Ste 120
Gainesville, VA 20155-3603

Phone

(703) 753-6772

NPI assigned

Sep 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ahmed Tarik Shinaishin, M.D.NPI 1497749055

Title

Pediatrician

Phone

(703) 753-6772

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 3

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

• Ahmed Tarik Shinaishin, MD

  • Pediatrics Physician
  • Gainesville, VA
  • NPI 1497749055
  NPD (past) Authorized official
• Susanne Blanchette Mackie-Lee, MD MPH

  • Pediatrics Physician
  • Gainesville, VA
  • NPI 1073504759
  NPD (past)
• Briony Jaine Peachey, NP

  • Nurse Practitioner
  • Gainesville, VA
  • NPI 1376566554
  NPD (past)

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1114352598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 IRON BAR LN STE 120",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553603",
            "telephone_number": "703-753-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 IRON BAR LN STE 120",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553603",
            "telephone_number": "703-753-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONES PEDIATRIC AND ADOLESCENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "SHINAISHIN",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "TARIK",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "703-753-6772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101239493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rose Michie
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• Meghan Park Mitchell, BCBA
• Mle Pastore, LLC
• Momentum Physical Therapy, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.