Organization Active NPI

Children'S Health Care Center of Nova

  • Pediatrics Physician
  • Manassas, VA
National Provider Identifier
1982859484
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101051497 Issued in VA
Legal business name
CHILDREN'S HEALTH CARE CENTER OF NOVA
Practice address
9001 Digges Rd Ste 106
Manassas, VA 20110-4414
Phone
(703) 392-5437
NPI assigned
Nov 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Dr. Bryan Wallace McEachern, M.D., F.A.A.P.NPI 1275501736
Title
Ceo/MD
Phone
(703) 392-5437

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 0101051497 VA Primary

Addresses

Primary practice location

9001 Digges Rd Ste 106
Manassas, VA 20110-4414

Mailing address

9001 Digges Rd Ste 106
Manassas, VA 20110-4414
Phone (703) 392-5437

Other identifiers 1

IdentifierTypeStateIssuer
006724264MedicaidVA

National Provider Directory

National Provider Directory

Locations

9001 Digges Rd
Ste 106
Manassas, VA 20110
Phone (703) 392-5437

Practitioners & affiliated clinicians

Practitioners 2

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": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1982859484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD STE 106",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104414",
            "telephone_number": "703-392-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 DIGGES RD STE 106",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104414",
            "telephone_number": "703-392-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTH CARE CENTER OF NOVA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "MCEACHERN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "703-392-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101051497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006724264",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.