Potomac Inova Healthcare Alliance, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

POTOMAC INOVA HEALTHCARE ALLIANCE, LLC

Practice address

4001 Prince William Pkwy
Woodbridge, VA 22192-7630

Phone

(703) 494-3309

Fax

(703) 357-9636

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Colleen Huelskamp

Title

Project Manager

Phone

(703) 204-6371

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodbridge CT Doing business as

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Inova Health Care Services

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Falls Church, VA
  • NPI 1568593440

  Member Of

  NPD member
• Potomac Hospital Corporation of Prince William

  • General Acute Care Hospital
  • Woodbridge, VA
  • NPI 1548366404

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1710151402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 TELESTAR CT",
            "address_2": "SUITE 3PI",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421207",
            "telephone_number": "571-423-5727",
            "fax_number": "571-423-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 PRINCE WILLIAM PKWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221927630",
            "telephone_number": "703-494-3309",
            "fax_number": "703-357-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC INOVA HEALTHCARE ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "HUELSKAMP",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "PROJECT MANAGER",
        "authorized_official_telephone_number": "703-204-6371"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "344745",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodbridge CT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Potomac Hospital
• Potomac Hospital
• Potomac Hospital Corporation of Prince William
• Potomac Hospital Corporation of Prince William
• Potomac Inova Healthcare Alliance
• Potomac Inova Healthcare Alliance, LLC
• Potomac Internal Medicine,PLLC
• Potomac Mills Family Dental
• Potomac Ophthalmology PC
• Potomac Orthodontics PLLC

• Radiology Clinic/Center in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Radiology Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.