NPIMap

Organization Active NPI

Vigor Integrative Wellness LLC

Doing business as Vigor Integrative Wellness

  • Multi-Specialty Clinic/Center
  • Rockville, MD
National Provider Identifier
1154036549
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
VIGOR INTEGRATIVE WELLNESS LLC
Doing business as
Vigor Integrative Wellness
Practice address
1201 Seven Locks Rd Ste 360
Rockville, MD 20854-6901
Phone
(301) 569-2502
NPI assigned
Jan 19, 2023
Last updated
Feb 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Kerniba GhoneimNPI 1568036382
Title
Owner
Phone
(301) 569-2502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

1201 Seven Locks Rd Ste 360
Rockville, MD 20854-6901

Mailing address

1201 Seven Locks Rd Ste 360
Rockville, MD 20854-6901

Other names 1

  • VIGOR INTEGRATIVE WELLNESS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230218000294 DC Part B Supplier - Clinic/Group Practice 6507238664 Receives reassigned benefits from 8 practitioners
Practice locations: Fairfax, VA; Washington, DC; Rockville, MD

National Provider Directory

National Provider Directory

Locations

1802 Vernon St NW
Ste 2225
Washington, DC 20009
Phone (301) 569-2502

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1154036549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 SEVEN LOCKS RD STE 360",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208546901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SEVEN LOCKS RD STE 360",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208546901",
            "telephone_number": "301-569-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIGOR INTEGRATIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "GHONEIM",
        "authorized_official_first_name": "KERNIBA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-569-2502"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIGOR INTEGRATIVE WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VIGOR INTEGRATIVE WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.