Pediatric Physicians of Reston, PC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

PEDIATRIC PHYSICIANS OF RESTON, PC

Practice address

1830 Town Center Dr
Suite # 205
Reston, VA 20190-3292

Phone

(703) 435-3636

Fax

(703) 435-9145

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rosemary J. Connolly, RT R

Title

Practice Manager

Phone

(703) 435-0325

Specialties & licenses 1

Addresses

Other names 1

• Reston Town Center Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841494796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 TOWN CENTER DR",
            "address_2": "SUITE # 205",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903292",
            "telephone_number": "703-435-3636",
            "fax_number": "703-435-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 TOWN CENTER DR",
            "address_2": "SUITE # 205",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903292",
            "telephone_number": "703-435-3636",
            "fax_number": "703-435-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PHYSICIANS OF RESTON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "703-435-0325",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RT R"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reston Town Center Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wanda M Patterson, M.D.
• Victory Paul-Ikhana
• Alex P. Pavidapha, M.D
• Peak Performance Physical Therapy, PLC
• Jeffrey Peckins, DPT
• Pediatrix Medical Group of the Mid-Atlantic PC
• Pediatrix Medical Group of the Mid-Atlantic PC
• Pediatrix Medical Group PC
• James Albert Pell, DDS
• Ariam Ivette Pena, M.A.

• Pediatric Adolescent Medicine Physician in Reston, VA
• Providers in Reston, VA by specialty
• Pediatric Adolescent Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.