NPIMap

Organization Active NPI

Resilient Roots: Functional and Evolutionary Medicine

  • General Practice Physician
  • Charlottesville, VA
National Provider Identifier
1184244774
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
RESILIENT ROOTS: FUNCTIONAL AND EVOLUTIONARY MEDICINE
Practice address
925 E Jefferson St
Charlottesville, VA 22902-5572
Phone
(434) 218-3425
Fax
(434) 215-0727
NPI assigned
Apr 23, 2020
Last updated
Apr 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Dr. Robert Abbott, MDNPI 1760910202
Title
Ceo, Medical Director
Phone
(757) 320-9383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

925 E Jefferson St
Charlottesville, VA 22902-5572

Mailing address

925 E Jefferson St
Charlottesville, VA 22902-5572
Phone (434) 218-3425

National Provider Directory

National Provider Directory

Locations

925 E Jefferson St
Charlottesville, VA 22902
Phone (434) 218-3425

Practitioners & affiliated clinicians

Practitioners 1

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": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1184244774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 E JEFFERSON ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025572",
            "telephone_number": "434-218-3425",
            "fax_number": "434-215-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 E JEFFERSON ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025572",
            "telephone_number": "434-218-3425",
            "fax_number": "434-215-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT ROOTS: FUNCTIONAL AND EVOLUTIONARY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "757-320-9383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.