NPIMap

Organization Active NPI

Johns Hopkins Regional Physicians LLC

  • Pediatric Cardiology Physician
  • Herndon, VA
National Provider Identifier
1245975796
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Practice address
171 Elden St Ste 2C4
Herndon, VA 20170-4875
Phone
(517) 612-2600
Fax
(571) 266-4096
NPI assigned
Apr 29, 2022
Organization subpart
Yes
Parent organization
JOHNS HOPKINS REGIONAL PHYSICIANS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Shavonda L Keating
Title
Director a/R Operations
Phone
(410) 933-6430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

171 Elden St Ste 2C4
Herndon, VA 20170-4875

Mailing address

171 Elden St Ste 2C4
Herndon, VA 20170-4875
Phone (517) 612-2600

Other names 1

  • CHILDREN'S HEART INSTITUTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101213000710 MD Part B Supplier - Clinic/Group Practice 3274720552 Receives reassigned benefits from 95 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Odenton, MD; Severna Park, MD; Rosedale, MD; Mount Airy, MD; Millersville, MD; Lutherville Timonium, MD; Lutherville, MD; Glen Burnie, MD…
O20180109000045 DC Part B Supplier - Clinic/Group Practice 3274720552 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fairfax, VA; Reston, VA; Herndon, VA; Laurel, MD

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Johns Hopkins Regional Phys54 organizations share this tax ID, including this one
Part of
Johns Hopkins Regional Phys

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

171 Elden St
Ste 2C4
Herndon, VA 20170
Phone (571) 612-2600

Practitioners & affiliated clinicians

Practitioners 10

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": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1245975796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ELDEN ST STE 2C4",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704875",
            "telephone_number": "517-612-2600",
            "fax_number": "571-266-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ELDEN ST STE 2C4",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704875",
            "telephone_number": "517-612-2600",
            "fax_number": "571-266-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS REGIONAL PHYSICIANS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS REGIONAL PHYSICIANS LLC",
        "enumeration_date": "2022-04-29",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR A/R OPERATIONS",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHILDREN'S HEART INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHILDREN'S HEART INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.