NPIMap

Organization Active NPI

NMG Affiliate Practice I, LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Haymarket, VA
National Provider Identifier
1154796696
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
NMG AFFILIATE PRACTICE I, LLC
Practice address
15225 Heathcote Blvd
Haymarket, VA 20169-6264
Phone
(703) 396-5292
Fax
(703) 396-5297
NPI assigned
Dec 9, 2015
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Geoffrey K Gardner
Title
VP of Finance
Phone
(703) 396-5292

Corporate family (same tax ID) 41

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

View all 41

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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
NMG Affilate Practice I LLC (42 organizations share this tax ID)

Locations

8180 Stonewall Shops Sq
Gainesville, VA 20155
Phone (703) 365-0227

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X

Addresses

NPPES NPI Registry

Primary practice location

15225 Heathcote Blvd
Haymarket, VA 20169-6264

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (703) 396-5292

Other names 1

NPPES NPI Registry
  • Novant Health UVA Health System Palliative Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 6, 2016.

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1154796696",
    "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": "703-396-5292",
            "fax_number": "703-396-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15225 HEATHCOTE BLVD",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201696264",
            "telephone_number": "703-396-5292",
            "fax_number": "703-396-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "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": "703-396-5292"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health UVA Health System Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haymarket, 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.