NPIMap

Organization Active NPI

Penguin Pediatrics

  • Pediatrics Physician
  • Ashburn, VA
National Provider Identifier
1982830873
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101034278 Issued in VA
Legal business name
PENGUIN PEDIATRICS
Practice address
44081 Pipeline PLZ
#125
Ashburn, VA 20147-5891
Phone
(571) 223-2229
Fax
(571) 223-3299
NPI assigned
Jun 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Authorized official

Name
Dr. Umesh Venkata Kodu, M.D.NPI 1295895431
Title
President
Phone
(571) 223-2229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 0101243313 VA
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X 0101034278 VA Primary

Addresses

Primary practice location

44081 Pipeline PLZ
#125
Ashburn, VA 20147-5891

Mailing address

44081 Pipeline PLZ
#125
Ashburn, VA 20147-5891
Phone (571) 223-2229

Other identifiers 2

IdentifierTypeStateIssuer
0101243313OtherVALICENSE NUMBER
0101034278OtherVALICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

24600 Millstream Dr
Ste 435
Aldie, VA 20105
Phone (703) 936-7709

24600 Millstream Dr
Ste 460
Aldie, VA 20105

44081 Pipeline Plz
Ste 125
Ashburn, VA 20147
Phone (517) 223-2229

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1982830873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44081 PIPELINE PLZ",
            "address_2": "#125",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475891",
            "telephone_number": "571-223-2229",
            "fax_number": "571-223-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44081 PIPELINE PLZ",
            "address_2": "#125",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475891",
            "telephone_number": "571-223-2229",
            "fax_number": "571-223-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENGUIN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "KODU",
        "authorized_official_first_name": "UMESH",
        "authorized_official_middle_name": "VENKATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-223-2229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101243313",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101034278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0101243313",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0101034278",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.