Dermatology & Dermatologic Surgery Group of Northern Virginia PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY & DERMATOLOGIC SURGERY GROUP OF NORTHERN VIRGINIA PLLC

Practice address

243 Church St NW
Vienna, VA 22180-4434

Phone

(703) 969-9944

NPI assigned

May 1, 2008

Last updated

Sep 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Linda P Nims, MDNPI 1922005537

Title

Sole Member

Phone

(703) 969-9944

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Linda Park Nims, M.D.

  • Procedural Dermatology Physician
  • Vienna, VA
  • NPI 1922005537

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Rebecca Rudd Barry, M.D.

  • Dermatology Physician
  • Vienna, VA
  • NPI 1538166798

  DC

  Medicare reassignment Care Compare group NPD
• Kelley Pagliai Redbord, MD

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1134252455

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1386810299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHURCH ST NW",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804434",
            "telephone_number": "703-969-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHURCH ST NW",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804434",
            "telephone_number": "703-969-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & DERMATOLOGIC SURGERY GROUP OF NORTHERN VIRGINIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "NIMS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "703-969-9944",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kemora Ashleigh Dent
• Dental Associates
• Dental Professionals of Virginia, P.C. (Covel, Stack and Henon,DDS,P.C.)
• Phabyan Depriest
• Selamawit Thomas Derese
• Dermutopia
• Dermutopia PLLC
• Sachit Desai, DO
• Randa Ahmed Desouky
• Ann Louise Devaney, M.S.W.

• Dermatology Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.