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PROVIDENCE HEALTH SERVICES, INC
NPI 1689005720
Orthopaedic Surgery - Sports Medicine in Washington, DC

Active since November 27, 2013
1160 VARNUM ST NE, DEPAUL 312, WASHINGTON, DC 20017(202) 534-4400(202) 435-4412 Get Directions Write a Review

NPPES record last updated: October 9, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Health Services, Inc NPPES

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

PROVIDENCE HEALTH SERVICES, INC (NPI 1689005720) is a healthcare organization registered as a sports medicine in Washington, District Of Columbia and active in the NPI registry since November 2013. The organization lists Beau Higginbotham, Vice President/coo, as its authorized official.

NPPES Registry Identity

NPI1689005720
Entity TypeOrganization
Primary Taxonomy207XX0005X
Legal Business NamePROVIDENCE HEALTH SERVICES, INC
Location Address1160 VARNUM ST NE, DEPAUL 312Washington, DC 20017-2107
Mailing AddressPo Box 418893Boston, MA 02241-8893 · (202) 448-4069 · Fax (202) 269-7825
Phone(202) 534-4400
Fax(202) 435-4412
Organization SubpartYesParent: Providence Hospital
Authorized OfficialBeau HigginbothamVice President/coo · (410) 368-3162
Enumeration DateNovember 27, 2013
Last NPPES UpdateOctober 9, 2017
✔ NPI 1689005720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in DC · HFD01-0212
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License HFD01-0212 (DC)
1160 VARNUM ST NE, Washington, DC 20017
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Other Identifiers 1

Medicare PIN602021DC

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.

MS. UCHENNA ANTHONIA OBICHERE CRNP
Nurse Practitioner (Psychiatric/Mental Health)
1160 VARNUM ST NE, SUITE 317
WASHINGTON, DC 20017
District of Columbia (202) 636-1130
PHS INTERNAL MEDICINE DP317
Internal Medicine
1160 VARNUM ST NE, DEPAUL 317
WASHINGTON, DC 20017
District of Columbia (202) 640-4837
YULIZA ABIGAIL LEMUS GAMES
Behavior Technician
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 525-1448
ANITA KUNWAR MD
Internal Medicine
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 854-7785
RESOURCE PHARMACY INCORPORATED
Pharmacist
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 832-2200
PHS MULTISPECIALTY SERVICES
Surgery
1160 VARNUM ST NE, DEPAUL 300
WASHINGTON, DC 20017
District of Columbia (202) 854-4014
PHS INTERNAL MEDICINE DP311
Internal Medicine
1160 VARNUM ST NE, DEPAUL 311
WASHINGTON, DC 20017
District of Columbia (202) 854-4470
BRANDI DENISE FISHER
Behavior Technician
1160 VARNUM ST NE
WASHINGTON, DC 20017
District of Columbia (202) 525-1448

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 Providence Health Services, Inc's NPI number?

The NPI number for Providence Health Services, Inc is 1689005720. It was assigned to this organization in the NPPES registry on November 27, 2013.

Where is Providence Health Services, Inc located?

Providence Health Services, Inc is located at 1160 Varnum St NE Depaul 312, Washington, DC 20017. The listed phone number is (202) 534-4400.

What is Providence Health Services, Inc's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

When was this NPI record last updated?

The NPPES record for Providence Health Services, Inc was last updated on October 9, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.