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

Individual provider Nursing Home Administrator · NPI 1780822841

Derrick John Mathis, ALFA is a Nursing Home Administrator in Manassas, Virginia. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2009
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Practice location Address checks out

9827 Sudley Manor Dr
Manassas, VA 20109-6232
Phone: (703) 530-7751
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Home Administrator (primary) Taxonomy 376G00000X · Licence 1706000192 (VA)

Record details

NPI number1780822841
Entity typeIndividual (Type 1)
GenderMale
Credentials ALFA
Sole proprietorYes
NPI enumeratedJanuary 28, 2009
Last updated in NPPESJanuary 28, 2009
Mailing address9827 Sudley Manor Dr, Manassas, VA 20109-6232

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