Active NPI
Somatus Whole Care Center of New Jersey P.C.
- Nephrology Physician
- McLean, VA
National Provider Identifier
1164187357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Legal business name
- SOMATUS WHOLE CARE CENTER OF NEW JERSEY P.C.
- Practice address
- 1861 International Drive, Ste 600
McLean, VA 22102-4420 - Phone
- (571) 992-0600
- NPI assigned
- Nov 3, 2021
- Last updated
- Nov 3, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ethan Ko, MD
- Title
- Authorized Official
- Phone
- (571) 244-7441
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | NU | Primary | |
| Case Management Agency | 251B00000X | NU |
Addresses
Primary practice location
1861 International Drive, Ste 600
McLean, VA 22102-4420
Mailing address
1861 International Drive, Ste 600
McLean, VA 22102-4420
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1635897600000",
"number": "1164187357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1861 INTERNATIONAL DRIVE, STE 600",
"city": "MCLEAN",
"state": "VA",
"postal_code": "221024420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1861 INTERNATIONAL DRIVE, STE 600",
"city": "MCLEAN",
"state": "VA",
"postal_code": "221024420",
"telephone_number": "571-992-0600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOMATUS WHOLE CARE CENTER OF NEW JERSEY P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2021-11-03",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A",
"authorized_official_last_name": "KO",
"authorized_official_first_name": "ETHAN",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "571-244-7441",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McLean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.