Century Pediatrics Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101054958 Issued in VA

Legal business name

CENTURY PEDIATRICS INC.

Practice address

2024 Opitz Blvd Ste a
Woodbridge, VA 22191-3388

Phone

(703) 492-7000

NPI assigned

Jan 3, 2007

Last updated

Sep 8, 2014By 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. Sridevi Madiraju, OFFICE MANAGER

Title

Vice President

Phone

(571) 334-6978

Specialties & licenses 1

Addresses

Other identifiers 9

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

CLIA laboratory certificates

Tax ID family

Century Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Century Pediatrics, Inc

  • Physician Assistant
  • Stafford, VA
  • NPI 1649666728
  NPD tax ID

Locations

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.

• Mark Allen Clark

  • Pediatric Nurse Practitioner
  • Fredericksburg, VA
  • NPI 1407903693
  NPD (past)
• Jahnnavi Madiraju, MD

  • Pediatrics Physician
  • Herndon, VA
  • NPI 1538780838
  NPD (past)
• Krishna Prasad Madiraju, M.D.FAAP

  • Pediatrics Physician
  • Woodbridge, VA
  • NPI 1376600759
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1558428953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22445 CONSERVANCY DR",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201488068",
            "telephone_number": "703-680-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 OPITZ BLVD STE A",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913388",
            "telephone_number": "703-492-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURY PEDIATRICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "MADIRAJU",
        "authorized_official_first_name": "SRIDEVI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "571-334-6978",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101054958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006720421",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006739491",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS PLUS WOODBR",
            "identifier": "259327",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010236568",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHKEEPERS PLUS STAFFO",
            "identifier": "386437",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "98446",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5686693",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE PPO",
            "identifier": "897801",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREDERICKSBURG HEALTHKEEP",
            "identifier": "189147",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.