PROVIDENCE HEALTH SERVICES INC NPI 1669453809

NPI Information

NPI: 1669453809
Provider Name: PROVIDENCE HEALTH SERVICES INC

Other Name: PROVIDENCE HOSPITAL

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1160 VARNUM ST NE
WASHINGTON, DC
ZIP 20017
Phone: (202) 854-7000
Get Directions

PROVIDENCE HEALTH SERVICES INC is a family medicine in Washington, DC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE HEALTH SERVICES INC NPI is 1669453809. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Providence Hospital.

The provider's business location address is:

1160 VARNUM ST NE
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 854-7000
Fax: (202) 269-7160

The provider's authorized official is Mitchell Lomax .
The authorized official title is Vice President/cfo and has the following contact phone number (667) 234-2926.

The enumeration date for this NPI number is 11/6/2005 and was last updated on 11/1/2023.

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
1	207R00000X	Internal Medicine				No
2	208600000X	Surgery				No
3	208M00000X	Hospitalist				No
4	103TH0100X	Psychologist	Health Service			No
5	251B00000X	Case Management		HFD01-0212	DISTRICT OF COLUMBIA	No
6	363L00000X	Nurse Practitioner				No
7	207Q00000X	Family Medicine				Yes

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
1	023435102	MEDICAID	DISTRICT OF COLUMBIA
2	023435100	MEDICAID	DISTRICT OF COLUMBIA
3	080352200	MEDICAID	DISTRICT OF COLUMBIA
4	5485215 00	MEDICAID	DISTRICT OF COLUMBIA
5	023435101	MEDICAID	MARYLAND
6	5485215 01	MEDICAID	MARYLAND

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: 4/28/2024

NPI Synchronization or Removal

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