M Clinic, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

0101239018 Issued in VA

Legal business name

M CLINIC, LLC

Practice address

406 Albemarle Square
Charlottesville, VA 22901

Phone

(434) 321-5257

Fax

(434) 321-5259

NPI assigned

Dec 8, 2017

Organization subpart

No

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

Authorized official

Name

Zachary Bush, M.D.

Title

Director of Clinical Affairs

Phone

(434) 321-5257

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1043725336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ALBEMARLE SQUARE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-321-5257",
            "fax_number": "434-321-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 ALBEMARLE SQUARE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-321-5257",
            "fax_number": "434-321-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "434-321-5257",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101239018",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101239018",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0101239018",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024166491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashley Lynn, LCSW
• Betty Hash Lyon, D.D.S.
• John Steven Lyon, D.D.S.
• Elizabeth A. Lyons, M.D.
• Kai Bader Lyons, CPM, LM
• M. Timberlake Inc
• Linglei Ma, MD
• Wei Feng Ma, MD
• Katherine Macallister, NP STUDENT
• Alison F Maccleery

• Endocrinology, Diabetes & Metabolism Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.