PROVIDENCE HEALTH SERVICES
NPI 1326316936
Internal Medicine in Washington, DC

Active since December 09, 2011CLIA 09D2273468 · Waiver
1140 VARNUM ST NE, PMB 202, WASHINGTON, DC 20017(202) 854-4242(202) 854-4245 Get Directions Write a Review

NPPES record last updated: September 6, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Providence Health Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH SERVICES (NPI 1326316936) is a healthcare organization registered as an internal medicine in Washington, District Of Columbia and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through December 12, 2026 and lists Charles F Haberkern, Vp, as its authorized official.

NPPES Registry Identity

NPI1326316936
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePHS INTERNAL MEDICINE PMB202
Location Address1140 VARNUM ST NE, PMB 202Washington, DC 20017-2151
Mailing Address1160 Varnum St Ne, St Catherine's Hall, Room 102Washington, DC 20017-2107 · (202) 854-4069 · Fax (202) 854-7825
Fax(202) 854-4245
Organization SubpartYesParent: Providence Hospital
Authorized OfficialCharles F HaberkernVp · (202) 854-4255
Enumeration DateDecember 9, 2011
Last NPPES UpdateSeptember 6, 2016
NPI 1326316936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in DC · HFD01-0212
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License HFD01-0212 (DC)
1140 VARNUM ST NE, Washington, DC 20017

Other Names 1

Other NameProvidence Health Services

Other Identifiers 4

Medicare PIN090006
Medicaid09810714VA
Medicaid029833400DC
Medicaid005145400MD

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 09D2273468

Providence Health System · Washington, DC
Active · expires Dec 12, 2026
CLIA Number09D2273468
Laboratory TypePhysician Office
Certificate Effective DateDecember 13, 2024
Certificate Expiration DateDecember 12, 2026
Laboratory DirectorDr. Shadi Soufi
Laboratory Phone(202) 854-7919
Laboratory LocationProvidence Health System1160 Varnum St NE, Washington, DC 20017
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Surgery
1140 VARNUM ST NE, STE 104
WASHINGTON, DC 20017
Specialist
1140 VARNUM ST NE, SUITE 102
WASHINGTON, DC 20017
Internal Medicine (Cardiovascular Disease)
1140 VARNUM ST NE, STE 040
WASHINGTON, DC 20017
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1140 VARNUM ST NE, SUITE 202
WASHINGTON, DC 20017
Physician Assistant (Medical)
1140 VARNUM ST NE, DR. STEPHEN SEABRON
WASHINGTON, DC 20017
Internal Medicine
1140 VARNUM ST NE, SUITE 208B
WASHINGTON, DC 20017
Registered Nurse (General Practice)
1140 VARNUM ST NE
WASHINGTON, DC 20017
Surgery
1140 VARNUM ST NE
WASHINGTON, DC 20017

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326316936, enumerated as an "organization" on December 09, 2011.

The provider is located at 1140 VARNUM ST NE PMB 202 WASHINGTON, DC 20017 and the phone number is (202) 854-4242.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.