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PROVIDENCE HEALTH SERVICES INC NPI 1689005720


NPI Information

NPI: 1689005720
Provider Name: PROVIDENCE HEALTH SERVICES, INC
Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

Address:
1160 VARNUM ST NE
DEPAUL 312
WASHINGTON, DC
ZIP 20017
Phone: (202) 534-4400
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PROVIDENCE HEALTH SERVICES, INC is a sports medicine orthopaedic surgery in Washington, DC. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. PROVIDENCE HEALTH SERVICES, INC NPI is 1689005720. The provider is registered as an organization entity type.

The provider's business location address is:

1160 VARNUM ST NE
DEPAUL 312
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 534-4400
Fax: (202) 435-4412

The provider's authorized official is Beau Higginbotham .
The authorized official title is Vice President/coo and has the following contact phone number (410) 368-3162.

The enumeration date for this NPI number is 11/27/2013 and was last updated on 10/9/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1282N00000XGeneral Acute Care HospitalHFD01-0212DISTRICT OF COLUMBIANo
2207XX0005XOrthopaedic SurgerySports MedicineHFD01-0212DISTRICT OF COLUMBIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1602021MEDICARE PINDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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