Organization Active NPI

Somatus Whole Care Center of New Jersey P.C.

  • Nephrology Physician
  • McLean, VA
National Provider Identifier
1164187357
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
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, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.