Healthy Kids Pediatric Center, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101234951 Issued in VA

Legal business name

HEALTHY KIDS PEDIATRIC CENTER, P.C.

Practice address

44075 Pipeline PLZ
Suite 210
Ashburn, VA 20147-5881

Phone

(703) 858-0121

Fax

(703) 858-0710

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Resa E Davis, M.D.NPI 1629170154

Title

President

Phone

(703) 858-0121

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Resa Elizabeth Davis, M.D

  • Pediatrics Physician
  • Ashburn, VA
  • NPI 1629170154
  NPD (past) Authorized official

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619184132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44075 PIPELINE PLZ",
            "address_2": "SUITE 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475881",
            "telephone_number": "703-858-0121",
            "fax_number": "703-858-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44075 PIPELINE PLZ",
            "address_2": "SUITE 210",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475881",
            "telephone_number": "703-858-0121",
            "fax_number": "703-858-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY KIDS PEDIATRIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RESA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-858-0121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101234951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.