NPIMap

Organization Active NPI

Pediatric Achievements, LLC

  • Specialist
  • Woodbridge, VA
National Provider Identifier
1720330277
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0119005220 Issued in VA
Legal business name
PEDIATRIC ACHIEVEMENTS, LLC
Practice address
2235 Tacketts Mill Dr Ste C
Woodbridge, VA 22192-3036
Phone
(703) 491-1044
Fax
(703) 491-2044
NPI assigned
Oct 9, 2012
Last updated
Oct 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Mrs. Erin M Clemens, OTR/LNPI 1457418121
Title
Director/Owner
Phone
(703) 491-1044

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
Specialist 174400000X 0119005220 VA Primary

Addresses

Primary practice location

2235 Tacketts Mill Dr Ste C
Woodbridge, VA 22192-3036

Mailing address

2235 Tacketts Mill Dr Ste C
Woodbridge, VA 22192-3036
Phone (703) 491-1044

National Provider Directory

National Provider Directory

Locations

2235 Tacketts Mill Dr
#C
Woodbridge, VA 22192
Phone (703) 491-1044

2239 Tacketts Mill Dr
#K
Woodbridge, VA 22192
Phone (703) 491-1044

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1720330277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 TACKETTS MILL DR STE C",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923036",
            "telephone_number": "703-491-1044",
            "fax_number": "703-491-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 TACKETTS MILL DR STE C",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221923036",
            "telephone_number": "703-491-1044",
            "fax_number": "703-491-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ACHIEVEMENTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "703-491-1044",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0119005220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.