Family Medicine
PHS FAMILY MEDICINE & PEDIATRICS PMB103
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1750659272 · enumerated 2011-12-12 · record updated 2016-09-06. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: Mr. CHARLES HABERKERN, VP · (202) 854-4255
Other names: PROVIDENCE HEALTH SERVICES
Addresses and phones
- Mailing address 1160 VARNUM ST NE, ST CATHERINE'S HALL, ROOM 102, WASHINGTON, DC, 20017-2107 (202) 854-4069 Fax (202) 854-7825 Google Maps Apple Maps OpenStreetMap
- Practice location 1140 VARNUM ST NE, PMB103, WASHINGTON, DC, 20017-2151 (202) 854-7074 Fax (202) 854-7470 Google Maps Apple Maps OpenStreetMap
Specialties
- Pediatrics 208000000X · License HFD01-0212 DC
- General Acute Care Hospital 282N00000X · License HFD01-0212 DC
- Family Medicine 207Q00000X · Primary · License HFD01-0212 DC
In this directory
Locations and evidence
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Practice location
WASHINGTON, DC, 200172151
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.