Kidmed Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

KIDMED INC.

Doing business as

KidMed Stafford

Practice address

20 Doc Stone Rd
Stafford, VA 22556-4515

Phone

(804) 647-2240

NPI assigned

Sep 12, 2017

Organization subpart

Yes

Parent organization

KIDMED INC.As reported in NPPES

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

Authorized official

Name

Dr. Mark A Flanzenbaum, MD

Title

President

Phone

(804) 592-5437

Specialties & licenses 1

Addresses

Other names 1

• KidMed Stafford Doing business as

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

CLIA laboratory certificates

Part of

Kidmed Inc

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1174042022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DOC STONE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564515",
            "telephone_number": "804-647-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DOC STONE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564515",
            "telephone_number": "804-647-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDMED INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIDMED INC.",
        "enumeration_date": "2017-09-12",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "FLANZENBAUM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-592-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidMed Stafford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tigist Ketema
• Melissa C Keylor, LPC
• Galam Asheaque Khan, M.D
• Rida Khan
• Kharis Care Partners
• Kids First Pediatrics of Stafford, PC
• Catherine Kim, PHARMD
• David Kim
• Michael K. Kim, M.D.
• Sun Hyun Kim, D.M.D

• Urgent Care Clinic/Center in Stafford, VA
• Providers in Stafford, VA by specialty
• Urgent Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.