NPIMap

Organization Active NPI

Martha Jefferson Hospital

Doing business as MJ Reproductive Technology Lab

  • Clinical Medical Laboratory
  • Charlottesville, VA
National Provider Identifier
1942397153
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MARTHA JEFFERSON HOSPITAL
Doing business as
MJ Reproductive Technology Lab
Practice address
595 Peter Jefferson Pkwy
3Rd Floor
Charlottesville, VA 22911
Phone
(434) 982-8520
Fax
(434) 982-8530
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elliot H Kuida
Title
VP/Coo
Phone
(434) 982-7326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X VA Primary

Addresses

Primary practice location

595 Peter Jefferson Pkwy
3Rd Floor
Charlottesville, VA 22911

Mailing address

595 Peter Jefferson Pkwy
3Rd Floor
Charlottesville, VA 22911
Phone (434) 982-8520

Other identifiers 1

IdentifierTypeStateIssuer
186753OtherVAANTHEM SERVICES

Other names 1

  • MJ Reproductive Technology Lab Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1011230Martha Jefferson Health & Wellness Services595 Peter Jefferson Drive - Suite 280, Charlottesville, VA 22911Certificate of waiverMay 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Robert Woodard7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

595 Martha Jefferson Dr
Fl 3
Charlottesville, VA 22911
Phone (434) 982-8520

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942397153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 PETER JEFFERSON PKWY",
            "address_2": "3RD FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22911",
            "telephone_number": "434-982-8520",
            "fax_number": "434-982-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 PETER JEFFERSON PKWY",
            "address_2": "3RD FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22911",
            "telephone_number": "434-982-8520",
            "fax_number": "434-982-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA JEFFERSON HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUIDA",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "434-982-7326"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM SERVICES",
            "identifier": "186753",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MJ Reproductive Technology Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • 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.