Ilya Zavelsky, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101054332 Issued in VA

Practice address

11127 Journal Pkwy
Ste 101
King George, VA 22485-3468

Phone

(540) 775-6891

Fax

(540) 775-6894

NPI assigned

Jan 13, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ilyazavelsky@kgp.allscriptsdirect.net

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.

• Shady Grove Pediatrics, PC

  • Pediatrics Physician
  • King George, VA
  • NPI 1285064758
  NPD (past) Authorized official
• Virginia Emergency Physicians LLP

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1134475999
  NPD (past)
• Virginia Emergency Physicians LLP

  • Emergency Medicine Physician
  • Richmond, VA
  • NPI 1639193188
  NPD (past)

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1336386309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12206 HUNTERS GLEN CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230596968",
            "telephone_number": "804-364-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11127 JOURNAL PKWY",
            "address_2": "STE 101",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224853468",
            "telephone_number": "540-775-6891",
            "fax_number": "540-775-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVELSKY",
        "first_name": "ILYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101054332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Williams, CNA
• Pauline Wills, M.A., CCC-SLP
• Jill Bain Wine, M.A., CCC-SLP
• La Wanda Wright
• Alena Yaseva

• Pediatrics Physician in King George, VA
• Providers in King George, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.