BLUE MANTLE MEDICINE PLLC
NPI 1417658980
Pediatrics in Fairfax, VA
About Blue Mantle Medicine Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE MANTLE MEDICINE PLLC (NPI 1417658980) is a healthcare organization registered as a pediatrics in Fairfax, Virginia and active in the NPI registry since March 2023. The organization holds a CLIA Waiver certificate valid through April 11, 2027 and lists Sita Canady, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Group Practice 1
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 49D2280070
Blue Mantle Medicine, PLLC · Fairfax, VAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FAIRFAX, VA 22033
FAIRFAX, VA 22033
FAIRFAX, VA 22033
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Mantle Medicine PLLC's NPI number?
The NPI number for Blue Mantle Medicine PLLC is 1417658980. It was assigned to this organization in the NPPES registry on March 13, 2023.
Where is Blue Mantle Medicine PLLC located?
Blue Mantle Medicine PLLC is located at 4001 Fair Ridge Dr Ste 305, Fairfax, VA 22033. The listed phone number is (540) 701-4767.
What is Blue Mantle Medicine PLLC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Does Blue Mantle Medicine PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 49D2280070) is associated with this NPI, valid through April 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Blue Mantle Medicine PLLC was last updated on March 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.
