Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health Services, Inc

Organization Family Medicine Physician · NPI 1619245222

Providence Health Services, Inc is a Family Medicine Physician in Washington, District of Columbia. Works from 2 locations. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

128 M St NW
Washington, DC 20001-1205
Phone: (202) 682-3840
Fax: (202) 682-3854
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1150 Varnum St Ne Rm 407, Washington, DC 20017-2180 — (202) 854-4069

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1619245222
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbotham — Vice President/Coo · (410) 638-3162
Other names Providence Health Services
NPI enumeratedDecember 9, 2011
Last updated in NPPESFebruary 6, 2020
Certification dateFebruary 6, 2020
Mailing address1150 Varnum St Ne Rm 407, Washington, DC 20017-2180

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