Organization Active NPI

Gerald Family Care

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1407056336
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GERALD FAMILY CARE
Practice address
1160 Varnum St NE
Ste 117
Washington, DC 20017-2107
Phone
(202) 832-7007
Fax
(202) 529-5290
NPI assigned
Jul 19, 2007
Last updated
Dec 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Kimberly Stewart
Title
Billing Manager
Phone
(301) 773-3752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1160 Varnum St NE
Ste 117
Washington, DC 20017-2107

Mailing address

PO Box 75492
Baltimore, MD 21275-5492
Phone (301) 773-3752

Other identifiers 1

IdentifierTypeStateIssuer
8702OtherDCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505001505 DC Part B Supplier - Clinic/Group Practice 3870581929 Receives reassigned benefits from 6 practitioners
Practice locations: Washington, DC; Capitol Heights, MD; Bowie, MD; Glenarden, MD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
09D0881438Gerald Family Care, PC #11160 Varnum Street,NE, Washington, DC 20017Certificate of waiverOct 4, 2026

National Provider Directory

National Provider Directory

Locations

2905 Mitchellville Rd
Ste 102
Bowie, MD 20716
Phone (301) 218-4101

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1407056336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75492",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755492",
            "telephone_number": "301-773-3752",
            "fax_number": "202-529-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "STE 117",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-832-7007",
            "fax_number": "202-529-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "301-773-3752"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8702",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.