Lara Mamikonian, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

0101251975 Issued in VA

Practice address

601 Children'S Lane
Children'S Hospital of the King'S Daughters
Norfolk, VA 23502

Phone

(585) 905-9377

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment NPD

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1154337954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDREN'S LANE",
            "address_2": "CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23502",
            "telephone_number": "585-905-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDREN'S LANE",
            "address_2": "CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23502",
            "telephone_number": "585-905-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMIKONIAN",
        "first_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "VA",
            "license": "0101251975",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101251975",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-00675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Silzle Maloney, ATR-BC, LPC, LMFT
• Michael Carlton Maloney, RPH
• Miranda L Maloney
• Tammy Jo Maloney, F.N.P.
• Mama J'S Transportation LLC
• Priscilla Mammen, MD
• Janette Marie Mance-Khourey, PH.D.
• Stephanie Marie Mancini, LCSW
• Donnamarie Lillian Mandara, FNP
• Lee Richard Mandel, M.D.

• Pediatric Critical Care Medicine Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Pediatric Critical Care Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.