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IMMACULATE MEDICAL SERVICES LLC
NPI 1821301904
Clinic/Center - Primary Care in Washington, DC

Active since July 19, 2010CLIA 09D2033464 · Waiver
106 IRVING ST NW, SUITE 308 SOUTH, WASHINGTON, DC 20010(202) 877-0400(202) 877-0584 Get Directions Write a Review

NPPES record last updated: February 15, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Immaculate Medical Services Llc NPPES

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

IMMACULATE MEDICAL SERVICES LLC (NPI 1821301904) is a healthcare organization registered as a primary care in Washington, District Of Columbia and active in the NPI registry since July 2010. The organization holds a CLIA Waiver certificate valid through December 1, 2027 and lists Ann Marie Gordon, Ceo, as its authorized official.

NPPES Registry Identity

NPI1821301904
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameIMMACULATE MEDICAL SERVICES LLC
Location Address106 IRVING ST NW, SUITE 308 SOUTHWashington, DC 20010-2927
Mailing Address2016 Gatewood PlSilver Spring, MD 20903-1505 · (301) 257-5033 · Fax (301) 408-3204
Phone(202) 877-0400
Fax(202) 877-0584
Organization SubpartNo
Authorized OfficialAnn Marie GordonCeo · (202) 877-0400
Enumeration DateJuly 19, 2010
Last NPPES UpdateFebruary 15, 2011
✔ NPI 1821301904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in DC · MD22148
Also ListedClinic/Center · Occupational MedicineTaxonomy 261QX0100X · License MD22148 (DC)
106 IRVING ST NW, Washington, DC 20010
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN491173MD

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 09D2033464

Immaculate Medical Services · Washington, DC
Active · expires Dec 1, 2027
CLIA Number09D2033464
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2025
Certificate Expiration DateDecember 1, 2027
Laboratory DirectorDr. Ann Marie Gordon
Laboratory Phone(202) 877-0400
Laboratory LocationImmaculate Medical Services106 Irving Street NW, Suite 308 South, Washington, DC 20010
CLIA data matches this NPI record on: Address Name Phone
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.

DR. RUMANA KAZMI M.D.
Pediatrics
106 IRVING ST NW, 306
WASHINGTON, DC 20010
District of Columbia (202) 291-2900
RUI LU
Internal Medicine (Endocrinology, Diabetes & Metabolism)
106 IRVING ST NW, SUITE 411 SOUTH
WASHINGTON, DC 20010
District of Columbia (202) 877-7080
MARIAH COVINGTON
Psychologist (Clinical Child & Adolescent)
106 IRVING ST NW
WASHINGTON, DC 20010
District of Columbia (202) 863-2282
MARGARET L MONTGOMERY CNM
Midwife
106 IRVING ST NW, SUITE 4700 NORTH
WASHINGTON, DC 20010
District of Columbia (202) 877-7479
DR. MARIE DRAOUI MD
Obstetrics & Gynecology
106 IRVING ST NW, SUITE 4400 NORTH
WASHINGTON, DC 20010
District of Columbia (202) 877-6933
MRS. LESLEY KATHRYN SANDERS PSYCHOLOGIST
Psychologist (Clinical)
106 IRVING ST NW, SUITE 2300
WASHINGTON, DC 20010
District of Columbia (301) 367-4827
SUSAN L LAESSIG MD
Internal Medicine (Gastroenterology)
106 IRVING ST NW, STE 205
WASHINGTON, DC 20010
District of Columbia (202) 829-0170
DR. MARTIN P KOLSKY M.D.
Ophthalmology
106 IRVING ST NW, SUITE 321
WASHINGTON, DC 20010
District of Columbia (202) 882-0200

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 Immaculate Medical Services LLC's NPI number?

The NPI number for Immaculate Medical Services LLC is 1821301904. It was assigned to this organization in the NPPES registry on July 19, 2010.

Where is Immaculate Medical Services LLC located?

Immaculate Medical Services LLC is located at 106 Irving St NW Suite 308 South, Washington, DC 20010. The listed phone number is (202) 877-0400.

What is Immaculate Medical Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Immaculate Medical Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 09D2033464) is associated with this NPI, valid through December 1, 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 Immaculate Medical Services LLC was last updated on February 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.