NPIMap

Organization Active NPI

Children's Multispecialty Clinic, PLC

  • Specialist
  • Herndon, VA
National Provider Identifier
1700217684
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101058336 Issued in VA
Legal business name
CHILDREN'S MULTISPECIALTY CLINIC, PLC
Practice address
171 Elden Street, Ste. 2C4
Herndon, VA 20170
Phone
(571) 612-2606
Fax
(703) 481-5804
NPI assigned
Dec 3, 2013
Last updated
Mar 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Authorized official

Name
Hasan I. Abdallah., M.D.NPI 1477504413
Title
Medical Director
Phone
(703) 481-5801

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 0101058336 VA Primary

Addresses

Primary practice location

171 Elden Street, Ste. 2C4
Herndon, VA 20170

Mailing address

P.O. Box 10066
MC Lean, VA 22102
Phone (571) 612-2600

National Provider Directory

National Provider Directory

Locations

19465 Deerfield Ave
Ste 310
Leesburg, VA 20176
Phone (703) 724-0410

Practitioners & affiliated clinicians

Practitioners 6

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": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1700217684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10066",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "22102",
            "telephone_number": "571-612-2600",
            "fax_number": "571-266-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ELDEN STREET, STE. 2C4",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "20170",
            "telephone_number": "571-612-2606",
            "fax_number": "703-481-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MULTISPECIALTY CLINIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-03",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "ABDALLAH.",
        "authorized_official_first_name": "HASAN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "703-481-5801",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101058336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.