=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629931704
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DC WILDFLOWER PUBLIC CHARTER SCHOOL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 913 55TH ST NE
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20019-7005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-996-8371
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 913 55TH ST NE
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20019-7005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-996-8371
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPECIAL EDUCATION POC
-----------------------------------------------------
Name | KARA THOMAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 202-996-8371
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------