Emerson Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EMERSON CLINIC

Practice address

508 Kennedy St NW Ste 207
Washington, DC 20011

Phone

(202) 239-0777

Fax

(202) 849-8814

NPI assigned

Jul 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Fabian Sandoval, MD

Title

Ceo

Phone

(202) 239-0777

Specialties & licenses 2

Addresses

Other names 1

• Emerson Community Clinic Doing business as

Locations

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1972099083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 KENNEDY ST NW STE 306",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200113010",
            "telephone_number": "202-239-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 KENNEDY ST NW STE 207",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20011",
            "telephone_number": "202-239-0777",
            "fax_number": "202-849-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERSON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-239-0777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerson Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emergency Medicine Associates
• Emerging Health Services LLP
• Emerging Life LLC
• Emerging Vision
• Shannon Leigh Emerick, MD
• Anthony Vane Emerson, HHA
• Florence Emerson
• Jack R Emerson, PT, DPT
• Lyndal Ray Emerson, M.D., PH.D.
• Paul Casey Emerson II

• All providers in Washington, DC
• Internal Medicine Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.