PHS CTR FOR GERIATRIC MEDICINE DP021 NPI 1538437926

NPI Information

  • NPI: 1538437926
  • Provider Name: PHS CTR FOR GERIATRIC MEDICINE DP021
  • Classification: Internal Medicine - 207RG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • Other Name: PROVIDENCE HEALTH SERVICES
  • Address: 1160 VARNUM ST NE
    DEPAUL 021
    WASHINGTON, DC
    ZIP 20017
  • Phone: (202) 854-7785

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NPI Details

PHS CTR FOR GERIATRIC MEDICINE DP021 is a geriatric medicine internal medicine in Washington, DC. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. PHS CTR FOR GERIATRIC MEDICINE DP021 NPI is 1538437926. The provider is registered as an organization entity type.
The provider Other Name Is Providence Health Services.

The provider's business location address is:

1160 VARNUM ST NE
DEPAUL 021
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 854-7785
Fax: (202) 854-7734

The provider's authorized official is Charles F Haberkern .
The authorized official title is Vp and has the following contact phone number (202) 854-4255.

The enumeration date for this NPI number is 12/13/2011 and was last updated on 9/6/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1282N00000XGeneral Acute Care HospitalHFD01-0212DISTRICT OF COLUMBIANo
2207RG0300XInternal MedicineGeriatric 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1029833400MEDICAIDDISTRICT OF COLUMBIA
2005145400MEDICAIDMARYLAND
309810714MEDICAIDVIRGINIA
4090006MEDICARE PIN

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: 3/30/2025

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