NPIMap

Organization Active NPI

VM Provision Care LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Tacoma, WA
National Provider Identifier
1164072765
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
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
Last updated
Sep 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Dr. Atif Mian, MDNPI 1700819307
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)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20191108001837 WA Part B Supplier - Clinic/Group Practice 7911339130 Receives reassigned benefits from 8 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

1614 S Mildred St
Ste B
Tacoma, WA 98465
Phone (253) 564-4233

3640 S Cedar St
Tacoma, WA 98409
Phone (253) 231-2292

3640 S Cedar St
Ste H
Tacoma, WA 98409

3640 S Cedar St
Ste O
Tacoma, WA 98409
Phone (253) 651-2498

Practitioners & affiliated clinicians

Practitioners 10

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": "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.

Verify at the official NPI Registry.