Minh D Ta (NPI# 1386930287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1386930287 |
| Entity Type | Individual |
| Full Name | Minh D Ta |
| Credential | M.D. |
| Gender | Male |
| Practice Address |
21785 Filigree Ct Ste 100 Ashburn VA 20147-6214 |
| Practice Telephone | 7035541100 |
| Mailing Address |
21785 Filigree Ct Ste 100 Ashburn VA 20147-6214 |
| Mailing Telephone | 7035541100 |
| Sole Proprietor | Yes, this individual is a Sole Proprietor |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2016-02-20 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| No | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | MT199021 | PA |
| No | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | D0078580 | MD |
| Yes | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | 0101257641 | VA |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396712816 | Minh C Ta | Optometrist | 2570 Blackmon Dr Ste 350, Decatur, GA 30033-6197 | 2006-03-02 |
| NPI | 1386930287 |
| PAC ID by PECOS | 7911229315 |
| Professional Enrollment ID | I20151105002167 |
| Full Name | Minh D Ta |
| Organization Legal Name | CENTRA MEDICAL GROUP, LLC |
| Phone Number | 4349473033 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | HOSPITALIST |
| Secondary Specialties | FAMILY PRACTICE |
| Group Practice PAC ID | 4789606088 |
| Number of Group Practice Members | 467 |
| Accepts Medicare Assignment | Y |
| Report Quality Measures | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490021 | CENTRA |
| Street Address |
21785 FILIGREE CT STE 100 |
| City | ASHBURN |
| State | VA |
| Zip Code | 20147-6214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144519190 | Monica Kanal | Internal Medicine | 21785 Filigree Ct Ste 100, Ashburn, VA 20147-6214 | 2011-03-30 |
| 1477943801 | Amanda Marie Dickey | Nurse Practitioner | 21785 Filigree Ct Ste 100, Ashburn, VA 20147-6214 | 2015-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033684154 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 44835 Russel Branch Parkway, Ashburn, VA 20147 | 2018-10-04 |
| 1417437203 | Roshni A Patel | Optometrist | 44050 Ashburn Village Blvd, Suite 163, Ashburn, VA 20147 | 2018-08-21 |
| 1972095974 | Verum Cutis Dermatology | Dermatology | 44110 Ashburn Shopping Plz Unit 237, Ashburn, VA 20147 | 2018-06-05 |
| 1255860680 | Aperiomics, Inc. | Clinical Medical Laboratory | 45085 University Dr, Ste 305, Ashburn, VA 20147 | 2017-06-08 |
| 1982053112 | Brian Kennedy | Student in an Organized Health Care Education/Training Program | 19998 Shadow Creek Ct, Ashburn, VA 20147 | 2016-06-08 |
| 1770939571 | Jared Reardon | Dentist | 20745 Williamsport Pl Ste 120, Ashburn, VA 20147 | 2016-05-11 |
| 1861853798 | Tetyana Mccain | Dentist | 42976 Nashua St, Ashburn, VA 20147 | 2016-03-20 |
| 1578920211 | Melissa Holbrook Walker | Physician Assistant | 21785 Filigree Court, Suite 101, Reston Radiology Consultants, Ashburn, VA 20147 | 2016-01-26 |
| 1144695180 | Olga Goncharov | Speech-Language Pathologist | 43255 Stillforest Ter., Ashburn, VA 20147 | 2015-12-02 |
| 1770975096 | Biogenomic Medicine Institute, Pllc | Psychiatry & Neurology | 45189 Research Place, Suite 150, Ashburn, VA 20147 | 2015-02-24 |
| Find all providers in zip 20147 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790888162 | Shilpa H Amin | Family Medicine | Belmont Country Club, Village of Baltrusol, 19756 Estancia Terrace, Ashburn, VA 20147 | 2006-09-07 |
| 1821107764 | Ashburn Medical Center PC | Family Medicine | 42882 Truro Parish Drive, Suite 201 Ashburn Medical Center PC, Ashburn, VA 20148 | 2006-08-30 |
| 1326056045 | Thomas Francis Morris | Family Medicine | 21170 Ashby Ponds Blvd, Ashburn, VA 20147-6128 | 2006-08-05 |
| 1609891316 | Neeta Goel | Family Medicine | 44095 Pipeline Plz, Ste 370, Ashburn, VA 20147-5898 | 2006-07-13 |
| 1508899907 | Patrina Lockette | Family Medicine | 354 E. Washington Ave., Ashburn, GA 31714-5222 | 2006-07-09 |
| 1215991948 | Mary R Renard | Family Medicine | 20905 Professional Plaza, Suite 330, Ashburn, VA 20147 | 2006-04-12 |
| 1174508055 | Earl A Lorenzen | Family Medicine | 354 E Washington Ave, Ashburn, GA 31714-5222 | 2005-12-13 |
| 1831615335 | Regina Vera Evidente | Family Medicine | 44790 Maynard Sq Ste 320, Ashburn, VA 20147-6514 | 2017-08-16 |
| 1861894222 | Capital Family Medicine Plc. | Family Medicine | 20925 Professional Plz, Suite 310, Ashburn, VA 20147-3403 | 2014-09-17 |
| 1528486230 | Lubna Rana | Family Medicine | 20925 Professional Plz, Suite 310, Ashburn, VA 20147-3403 | 2014-03-31 |
| Find all providers in ASHBURN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.