Individual provider Active NPI

Laura Wheat Tilman, D.O.

  • Pediatrics Physician
  • Falls Church, VA
National Provider Identifier
1689022188
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102205710 Issued in VA
Practice address
3300 Gallows Rd
Inova Childrens Hospital Pediatric Residency Program
Falls Church, VA 22042-3307
Phone
(703) 776-7834
Fax
(703) 776-4323
NPI assigned
May 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0116029012 VA
Pediatrics Physician 208000000X 0102205710 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Inova Childrens Hospital Pediatric Residency Program
Falls Church, VA 22042-3307

Mailing address

PO Box 37174
Baltimore, MD 21297-3174
Phone (571) 423-5699

Other practice location 1

25055 Riding Plz Ste 150
South Riding, VA 20152-5919
Phone (703) 322-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190910001984 DC Practitioner - Pediatric Medicine 2961731328 Reassigns benefits to 1 organization
I20191001000668 VA Practitioner - Pediatric Medicine 2961731328 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0116029012VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Aug 12, 2019 Accepting new patients
Inova Health Care Services CurrentSince Aug 12, 2019 Accepting new patients
Inova Health Care Services Pediatrics CurrentSince Aug 12, 2019 Accepting new patients
Pediatrix Medical Group of the Mid-Atlantic PC PastSince Aug 1, 2020 Accepting new patients

Locations

13135 Route 50
Ste 201
Fairfax, VA 22033
Phone (703) 391-0900

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1689022188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37174",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973174",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "address_2": "INOVA CHILDRENS HOSPITAL PEDIATRIC RESIDENCY PROGRAM",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-7834",
            "fax_number": "703-776-4323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25055 Riding Plz Ste 150",
            "address_purpose": "LOCATION",
            "city": "South Riding",
            "state": "VA",
            "postal_code": "201525919",
            "country_code": "US",
            "telephone_number": "703-322-0245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILMAN",
        "first_name": "LAURA",
        "middle_name": "WHEAT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0116029012",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102205710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.