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BOULEVARD CENTER PEDIATRICS
NPI 1568706158
Pediatrics in Dumfries, VA

Active since November 20, 2012CLIA 49D0692122 · Waiver
3733 FETTLER PARK DR., DUMFRIES, VA 22025(703) 670-0300(703) 291-5331 Get Directions Write a Review

NPPES record last updated: February 20, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Boulevard Center Pediatrics NPPES

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

BOULEVARD CENTER PEDIATRICS (NPI 1568706158) is a healthcare organization registered as a pediatrics in Dumfries, Virginia and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through May 31, 2028 and lists Anita Gohel, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1568706158
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBOULEVARD CENTER PEDIATRICS
Location Address3733 FETTLER PARK DR.Dumfries, VA 22025
Mailing Address3733 Fettler Park Dr.Dumfries, VA 22025 · (703) 670-0300 · Fax (703) 291-5331
Phone(703) 670-0300
Fax(703) 291-5331
Organization SubpartNo
Authorized OfficialAnita GohelPractice Manager · (703) 670-0300
Enumeration DateNovember 20, 2012
Last NPPES UpdateFebruary 20, 2019
✔ NPI 1568706158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in VA · 0101244499
Definition
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.
3733 FETTLER PARK DR., Dumfries, VA 22025
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 49D0692122

Boulevard Center Pediatrics Inc · Dumfries, VA
Active · expires May 31, 2028
CLIA Number49D0692122
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorShailesh K. Gohel
Laboratory Phone(703) 670-0300
Laboratory LocationBoulevard Center Pediatrics Inc3733 Fettler Park Dr, Dumfries, VA 22025
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Boulevard Center Pediatrics's NPI number?

The NPI number for Boulevard Center Pediatrics is 1568706158. It was assigned to this organization in the NPPES registry on November 20, 2012.

Where is Boulevard Center Pediatrics located?

Boulevard Center Pediatrics is located at 3733 Fettler Park Dr., Dumfries, VA 22025. The listed phone number is (703) 670-0300.

What is Boulevard Center Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Boulevard Center Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0692122) is associated with this NPI, valid through May 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Boulevard Center Pediatrics was last updated on February 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.