JHU - 4102 WILSON BLVD
NPI 1790504066
Clinic/Center - Multi-Specialty in Arlington, VA
NPI Status: Active since October 04, 2024
Contact Information
4102 WILSON BLVD
ARLINGTON, VA
ZIP 22203
Phone: (703) 462-1777
Fax: (703) 657-1192
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 49D2305283
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-28-2026
About JHU - 4102 WILSON BLVD
This page provides the complete NPI Profile along with additional information for Jhu - 4102 Wilson Blvd, a provider established in Arlington, Virginia operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1790504066 assigned on October 2024. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Jhu - 4102 Wilson Blvd operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Jhu - 4102 Wilson Blvd. The authorized official of this NPI record is Nicholas Giarratano (Director Provider Enrollment Unit)
- NPI
- 1790504066
- Provider Legal Name
- JOHNS HOPKINS UNIVERSITY
- Other Organization Name
- JHU - 4102 WILSON BLVD
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4102 WILSON BLVD ARLINGTON, VA 22203
- Location Phone
- (703) 462-1777
- Location Fax
- (703) 657-1192
- Mailing Address
- 6201 GREENLEIGH AVE MIDDLE RIVER, MD 21220
- Mailing Phone
- (410) 933-6423
- Mailing Fax
- (703) 657-1192
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-04-2024
- Last Update Date
- 10-29-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 152W00000X | Eye and Vision Services Providers | Optometrist | |
| 2 | 207VF0040X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 3 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | |
| 4 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 5 | 208800000X | Allopathic & Osteopathic Physicians | Urology |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 49D2305283
- Facility Type
- Physician Office
- Certificate Effective Date
- May 29, 2024
- Certificate Expiration Date
- May 28, 2026
- Laboratory Director
- KAMAL DEOL
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Jhu - 4102 Wilson Blvd in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 9 | 0 | 5 | 0 | 4 | 0 | 6 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 10 | 0 | 8 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 1 + 0 + 0 + 8 + 0 + 1 + 2 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1790504066 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
JOHNS HOPKINS COMMUNITY PHYSICIANS
Internal Medicine
4102 WILSON BLVD
ARLINGTON, VA
ZIP 22203
JOHNS HOPKINS UNIVERSITY
Optometrist
4102 WILSON BLVD
ARLINGTON, VA
ZIP 22203
DR. SONJA BRITT BORGSTROM MD, MPH
Family Medicine
4102 WILSON BLVD
ARLINGTON, VA
ZIP 22203
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790504066, enumerated as an "organization" on October 04, 2024.
The provider is located at 4102 WILSON BLVD ARLINGTON, VA 22203 and the phone number is (703) 462-1777.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
