Integrative Medicine & Virtualcare Plus LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRATIVE MEDICINE & VIRTUALCARE PLUS LLC

Practice address

5212A Kings Mills Rd # 529
Mason, OH 45040-2319

Phone

(614) 653-7351

NPI assigned

Nov 7, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peng Ethan Wang, DO

Title

Internist/Owner

Phone

(614) 653-7351

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1033754569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 MARBLE RIDGE LN",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402175",
            "telephone_number": "614-653-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212A KINGS MILLS RD # 529",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402319",
            "telephone_number": "614-653-7351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4665 E Galbraith Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452362783",
            "country_code": "US",
            "telephone_number": "614-653-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE & VIRTUALCARE PLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "PENG",
        "authorized_official_middle_name": "ETHAN",
        "authorized_official_title_or_position": "INTERNIST/OWNER",
        "authorized_official_telephone_number": "614-653-7351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mason, OH
• Providers in Mason, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.