Whitman-Walker Clinic, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Washington, DC
NPI 1821113341 · NPPES record last updated Apr 11, 2025
Key facts
- NPI
- 1821113341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- WHITMAN-WALKER CLINIC, INC.
- Practice address
- 1201 Sycamore Dr SE
Washington, DC 20032-5956 - Phone
- (202) 745-7000
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Naseema B Shafi
- Title
- Ceo
- Phone
- (202) 797-3572
Owners & managing parties with NPI records 1
-
Sarah Luise Henn, M.D.,MPH
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 10
Practitioners 32
-
Florence Bristy Rozario, M.A, LGPC
-
Pele Solell-Knepler, DNP, FNP-C, RN, BSN
-
Stephen E Abbott, MD
-
Minerva Andre, DO
-
Kyle R Benda, DO
-
Barry Paul Clark, MD
-
Joseph Darrell Cribb Jr., AGPCNP
-
Milan Noel Flanagan, DNP
-
Sarah Luise Henn, M.D.,MPH
-
Andrea N Hulse, MD
-
Sarah King, FNP-BC
-
Joseph Michael Wrenn, LICSW
-
Tanuja Devaraj, M.D
-
Randall Drake Ehrbar, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
Federally qualified health center certification: CCN 091848
- Legal name
- WHITMAN-WALKER CLINIC, INC.
- Doing business as
- WHITMAN WALKER HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 28, 2013
- Last certification
- Mar 28, 2013
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 13, 1978 in WA
- Enrollment address
- 1201 Sycamore Dr SE
Washington, DC 20032-5956
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Meghan Davies |
Corporate Director | Jun 1, 2018 | |
| Lorrie McHugh |
Corporate Officer | Jun 1, 2018 | |
| Andre Eleazer |
Corporate Officer |
Sep 1, 2010 | |
| Donald B Blanchon |
Corporate Officer |
May 1, 2006 | |
| Operational/Managerial Control | May 1, 2006 | ||
| Naseema B Shafi |
Corporate Officer |
May 29, 2007 | |
| Alison M Gill |
Corporate Officer | Jun 1, 2018 | |
| Sandy James |
Corporate Officer | Jun 1, 2018 | |
| Ann Bonham |
Corporate Officer | Jun 1, 2018 | |
| Sarah L. Henn |
Corporate Director | Jun 1, 2018 | |
| Travis Patton |
Corporate Officer | Jun 1, 2018 | |
| Winifred Quinn |
Corporate Director | Feb 26, 2013 | |
| Consuella Lopez |
Corporate Officer | Jun 1, 2018 | |
| James Rollins |
Corporate Officer | Jun 1, 2018 | |
| Thomas H Bullock |
Corporate Officer | Jun 1, 2018 | |
| Harry Fox |
Corporate Officer | Jun 1, 2018 | |
| Wade Harman |
Corporate Officer | Jun 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130328000507 | DC | Part a Provider - Federally Qualified Health Center (FQHC) | 6507755196 | Practice locations: Washington, DC |
National Provider Directory
- Tax ID family
- Whitman Walker Clinic Inc
Locations
1377 R St NW
Ste 200
Washington, DC 20009
Phone (202) 745-7000
1377 R St NW
Ste 2
Washington, DC 20009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | DC | Yes | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X |
Addresses
Primary practice location
1201 Sycamore Dr SE
Washington, DC 20032-5956
Mailing address
1377 R St NW FL NW2
Washington, DC 20009-6293
Phone (202) 745-7000
Other practice location 1
2301 Martin Luther King, Jr., Ave, SE
Washington, DC 20020
Phone (202) 745-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 094518400 | Medicaid | DC | |
| 19094 | Other | DC | CHARTERED ALLIANCE |
| 038947600 | Medicaid | DC | |
| 5590 | Other | DC | HEALTH RIGHT INC. |
| 094870800 | Medicaid | DC |
Other names
- Whitman Walker Health
Other providers in Washington, DC
- Whitman-Walker Clinic Inc.
- Whitman-Walker Clinic Inc.
- Whitman-Walker Clinic, Inc
- Whitman-Walker Clinic, Inc
- Whitman-Walker Clinic, Inc.
- Whitman-Walker Health
- Whitman-Walker Health
- Grace Arinton Whitman
- Natalia Borisovna Whitman
- Chaylena Whitmire
All providers in Washington, DC · Federally Qualified Health Center (FQHC) in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.