BLUE MANTLE MEDICINE PLLC – NPI #1417658980
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Health Care Provider Taxonomy Code for Pediatrics

BLUE MANTLE MEDICINE PLLC is a provider located in FAIRFAX, VA. NPPES has assigned the NPI number 1417658980 to BLUE MANTLE MEDICINE PLLC on March 13, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLUE MANTLE MEDICINE PLLC below.

NPI Profile for
BLUE MANTLE MEDICINE PLLC

NPI Number
1417658980
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLUE MANTLE MEDICINE PLLC
Primary location
4001 FAIR RIDGE DR STE 305
FAIRFAX, VA 22033-2917
Phone: (540) 701-4767 Fax: (703) 520-9880
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SITA CANADY
MD
Phone: (540) 645-1856
Updated
Certification Date
Mar 13, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.