Active NPI
Rachel Flaks Waldman, PA
- Physician Assistant
- Clarksville, MD
National Provider Identifier
1871867903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C02870
- Practice address
- 6500 Burgundy LN
Clarksville, MD 21029-2600 - Phone
- (703) 994-0030
- NPI assigned
- Mar 7, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C02870 | MD | Primary |
Addresses
Primary practice location
6500 Burgundy LN
Clarksville, MD 21029-2600
Mailing address
6500 Burgundy LN
Clarksville, MD 21029-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331078400000",
"number": "1871867903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6500 BURGUNDY LN",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210292600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6500 BURGUNDY LN",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210292600",
"telephone_number": "703-994-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDMAN",
"first_name": "RACHEL",
"middle_name": "FLAKS",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-07",
"last_updated": "2012-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C02870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.