| Greater Prince William Area Community Health Center Inc | |
|
3350 Commission Ct Woodbridge VA 22192-1784 | |
| (703) 680-7950 | |
| (703) 680-7953 |
| Full Name | Greater Prince William Area Community Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3350 Commission Ct, Woodbridge, Virginia |
| Authorized Official Name and Position | Mark Meye (CEO) |
| Authorized Official Contact | 7036806524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Prince William Area Community Health Center Inc 3350 Commission Ct Woodbridge VA 22192-1784 Ph: (703) 680-7950 | Greater Prince William Area Community Health Center Inc 3350 Commission Ct Woodbridge VA 22192-1784 Ph: (703) 680-7950 |
| NPI Number | 1366591562 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 12/18/2023 |
| Medicare PECOS PAC ID | 9436258209 |
|---|---|
| Medicare Enrollment ID | O20070619000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366591562 | NPI | - | NPPES |
| 1366591562 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Rachel A Jansen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952453482 PECOS PAC ID: 4789784869 Enrollment ID: I20070703000516 |
| Provider Name | Michael Q Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053302513 PECOS PAC ID: 2769498252 Enrollment ID: I20080312000506 |
| Provider Name | Rashid A Mohiuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881627834 PECOS PAC ID: 8123024718 Enrollment ID: I20100519000616 |
| Provider Name | Nitu V Pandit |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760597843 PECOS PAC ID: 2961688064 Enrollment ID: I20110524000888 |
| Provider Name | Syed K Mahboob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770760944 PECOS PAC ID: 8729102728 Enrollment ID: I20151221000299 |
| Provider Name | Hussien A Al-shammaa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093765646 PECOS PAC ID: 7517247067 Enrollment ID: I20161129002619 |
| Provider Name | Jean-andre Constant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952442717 PECOS PAC ID: 3476828237 Enrollment ID: I20171004000591 |
| Provider Name | Deborah J Yuan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356823215 PECOS PAC ID: 7012252828 Enrollment ID: I20181226001605 |
| Provider Name | Lauren E Agyekum |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790277846 PECOS PAC ID: 7810244126 Enrollment ID: I20191011001692 |
| Provider Name | Teresa Mary Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073166096 PECOS PAC ID: 8628400868 Enrollment ID: I20191108002818 |
| Provider Name | Linda Brown Trudel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043262835 PECOS PAC ID: 3779551346 Enrollment ID: I20210324002527 |
| Provider Name | Dristi Basnet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407447931 PECOS PAC ID: 0244647527 Enrollment ID: I20210405000123 |
| Provider Name | Nury Salazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083227300 PECOS PAC ID: 9931595295 Enrollment ID: I20220413001877 |
| Provider Name | Monique Nichole Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356013908 PECOS PAC ID: 1456738749 Enrollment ID: I20220505002215 |
| Provider Name | Maureen Breslin Romano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427781657 PECOS PAC ID: 5799160263 Enrollment ID: I20220920000757 |
| Provider Name | Connie Van Baah |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285146076 PECOS PAC ID: 8426426628 Enrollment ID: I20221118002216 |
| Provider Name | Sushma Shrestha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548975949 PECOS PAC ID: 7719343698 Enrollment ID: I20230518002486 |
| Provider Name | Baburam Thapa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215466875 PECOS PAC ID: 1254603749 Enrollment ID: I20230628000357 |
| Provider Name | Jayla Brianna Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134714439 PECOS PAC ID: 9739571746 Enrollment ID: I20230925003488 |
| Provider Name | Krystal Howard Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104474428 PECOS PAC ID: 3779910740 Enrollment ID: I20231012000750 |
| Provider Name | Patricia Crosby |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1386097517 PECOS PAC ID: 4284085523 Enrollment ID: I20240110004449 |
| Provider Name | Zaida I Dayton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114349909 PECOS PAC ID: 6901257104 Enrollment ID: I20240112000649 |
| Provider Name | Ramfis Luis Marquez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346505963 PECOS PAC ID: 5991156010 Enrollment ID: I20240112001413 |
| Provider Name | Patricia Crosby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386097517 PECOS PAC ID: 4284085523 Enrollment ID: I20240116000028 |
| Provider Name | June L Toth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093162356 PECOS PAC ID: 7315399185 Enrollment ID: I20240117001777 |
| Provider Name | Timothy M Spitzer |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1447440862 PECOS PAC ID: 3971801366 Enrollment ID: I20240314001947 |
| Provider Name | Francisco Javier Cornejo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316717952 PECOS PAC ID: 9234579244 Enrollment ID: I20240424002067 |
| Provider Name | Sachi Desai Patel |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1063854818 PECOS PAC ID: 7012237068 Enrollment ID: I20240503001737 |
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