NPIMap

Organization Active NPI

Providence Hospital

  • Primary Care Clinic/Center
  • Silver Spring, MD
National Provider Identifier
1134584667
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
RN1014643 Issued in DC
Legal business name
PROVIDENCE HOSPITAL
Practice address
3413 Olive Branch Dr
Silver Spring, MD 20904-4973
Phone
(301) 256-7630
NPI assigned
Dec 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Yiesak AsfawNPI 1487019030
Title
NP
Phone
(301) 256-7630

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
Primary Care Clinic/Center 261QP2300X RN1014643 DC Primary

Addresses

Primary practice location

3413 Olive Branch Dr
Silver Spring, MD 20904-4973

Mailing address

1150 Varnum St NE
Wahington DC, DC 20017
Phone (202) 854-7000

National Provider Directory

National Provider Directory
Tax ID family
PHS Ctr for Geriatric Medicine Dp02123 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1134584667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE",
            "city": "WAHINGTON DC",
            "state": "DC",
            "postal_code": "20017",
            "telephone_number": "202-854-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 OLIVE BRANCH DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209044973",
            "telephone_number": "301-256-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "ASFAW",
        "authorized_official_first_name": "YIESAK",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "301-256-7630"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "DC",
            "license": "RN1014643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.