1942458187 NPI number — AVERY HEALTHCARE ASSOCIATES,P.C.

Table of content: (NPI 1942458187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942458187 NPI number — AVERY HEALTHCARE ASSOCIATES,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AVERY HEALTHCARE ASSOCIATES,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942458187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
650 PENNSYLVANIA AVE SE
Provider Second Line Business Mailing Address:
SUITE 320
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20003-4318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-546-6522
Provider Business Mailing Address Fax Number:
202-547-3559

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 PENNSYLVANIA AVE SE
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20003-4318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-546-6522
Provider Business Practice Location Address Fax Number:
202-547-3559
Provider Enumeration Date:
08/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
AVERY
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
H.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
202-546-6522

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD16537 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 025922700 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05205 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 15097 . This is a "CHATERED HEALTH PLAN" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 817127 . This is a "OPTIMUM CHOICE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 817127 . This is a "MDIPA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: A123-0001 . This is a "CAREFIRST BLUE CROSS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 41530 . This is a "AETNA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 217127 . This is a "ONENET" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 6535012 . This is a "CIGNA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 910900 . This is a "HEALTHKEEPERS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 1462425 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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