NPIMap

Organization Active NPI

NMG Affiliate Practice I, LLC

Doing business as Novant Health UVA Health System Express Care

  • Family Medicine Physician
  • Warrenton, VA
National Provider Identifier
1154796373
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NMG AFFILIATE PRACTICE I, LLC
Doing business as
Novant Health UVA Health System Express Care
Practice address
480 Fletcher Dr Ste 3
Warrenton, VA 20186-2185
Phone
(571) 284-1220
Fax
(540) 680-2879
NPI assigned
Dec 14, 2015
Last updated
Apr 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Authorized official

Name
Geoffrey K Gardner
Title
VP of Finance
Phone
(571) 284-1250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X VA Primary

Addresses

Primary practice location

480 Fletcher Dr Ste 3
Warrenton, VA 20186-2185

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (571) 284-1250

Other names 1

  • Novant Health UVA Health System Express Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110311000151 VA Part B Supplier - Clinic/Group Practice 4688587967 Receives reassigned benefits from 608 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Manassas, VA; Haymarket, VA; Keswick, VA; Prince William, VA; Richmond, VA; South Riding, VA; Warrenton, VA; Winchester, VA…

National Provider Directory

National Provider Directory
Tax ID family
Uva Community Health Medical Group LLC42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Practitioners & affiliated clinicians

Practitioners 2

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": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1154796373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "571-284-1250",
            "fax_number": "540-680-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 FLETCHER DR STE 3",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862185",
            "telephone_number": "571-284-1220",
            "fax_number": "540-680-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "571-284-1250"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health UVA Health System Express Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warrenton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.