Active NPI
VM Provision Care LLC
- Geriatric Medicine (Internal Medicine) Physician
- Tacoma, WA
National Provider Identifier
1164072765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- Legal business name
- VM PROVISION CARE LLC
- Practice address
- 3640 S Cedar St Ste O
Tacoma, WA 98409-5700 - Phone
- (253) 651-2498
- NPI assigned
- Sep 16, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Atif Mian, MD
- Title
- Ceo
- Phone
- (253) 651-2498
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | Primary |
Addresses
Primary practice location
3640 S Cedar St Ste O
Tacoma, WA 98409-5700
Mailing address
PO Box 64375
Tacoma, WA 98464-0375
Phone (253) 651-2498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191108001837 | WA | Part B Supplier - Clinic/Group Practice | 7911339130 |
Receives reassigned benefits from 8 practitioners Practice locations: Tacoma, WA |
National Provider Directory
National Provider DirectoryLocations
3640 S Cedar St
Ste H
Tacoma, WA 98409
3640 S Cedar St
Tacoma, WA 98409
Phone (253) 231-2292
3640 S Cedar St
Ste O
Tacoma, WA 98409
Phone (253) 651-2498
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Lakewood, WA
- NPI 1427499169
-
- Psychiatric/Mental Health Nurse Practitioner
- Olympia, WA
- NPI 1336240902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568592000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1568592000000",
"number": "1164072765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64375",
"city": "TACOMA",
"state": "WA",
"postal_code": "984640375",
"telephone_number": "253-651-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3640 S CEDAR ST STE O",
"city": "TACOMA",
"state": "WA",
"postal_code": "984095700",
"telephone_number": "253-651-2498"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VM PROVISION CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-16",
"last_updated": "2019-09-16",
"status": "A",
"authorized_official_last_name": "MIAN",
"authorized_official_first_name": "ATIF",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "253-651-2498",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.