NPIMap

Organization Active NPI

Watoto Pediatric & Adolescent Specialty, LLC

  • Pediatrics Physician
  • Gainesville, VA
National Provider Identifier
1457585481
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WATOTO PEDIATRIC & ADOLESCENT SPECIALTY, LLC
Practice address
7915 Lake Manassas Drive
Suite 209
Gainesville, VA 20155-3260
Phone
(571) 248-0679
Fax
(571) 261-9549
NPI assigned
May 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Authorized official

Name
Dr. Irving C Williams II, M.D.NPI 1992785489
Title
Physician/Owner
Phone
(571) 248-0679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7915 Lake Manassas Drive
Suite 209
Gainesville, VA 20155-3260

Mailing address

7915 Lake Manassas Drive
Suite 209
Gainesville, VA 20155-3260
Phone (571) 248-0679

National Provider Directory

National Provider Directory

Locations

7915 Lake Manassas Dr
Ste 209
Gainesville, VA 20155
Phone (571) 248-0679

Practitioners & affiliated clinicians

Practitioners 3

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": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1457585481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DRIVE",
            "address_2": "SUITE 209",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553260",
            "telephone_number": "571-248-0679",
            "fax_number": "571-261-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7915 LAKE MANASSAS DRIVE",
            "address_2": "SUITE 209",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553260",
            "telephone_number": "571-248-0679",
            "fax_number": "571-261-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATOTO PEDIATRIC & ADOLESCENT SPECIALTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "571-248-0679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.