Mission Functional Medicine, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102202773 Issued in VA

Legal business name

MISSION FUNCTIONAL MEDICINE, PLLC

Practice address

230 Costello Dr Ste 210
Winchester, VA 22602-4310

Phone

(540) 247-8476

Fax

(540) 869-3524

NPI assigned

Jul 13, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Shawn C Lawson

Title

Office Manager

Phone

(540) 247-8476

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Laura Nelson Lawson, DO

  • Family Medicine Physician
  • Winchester, VA
  • NPI 1295869543
  Medicare reassignment Care Compare group NPD
• Erica L Ganz, PA-C

  • Physician Assistant
  • Winchester, VA
  • NPI 1346522612
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1225514136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CHANCELLORSVILLE DR",
            "city": "STEPHENS CITY",
            "state": "VA",
            "postal_code": "226554515",
            "telephone_number": "540-247-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 COSTELLO DR STE 210",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024310",
            "telephone_number": "540-247-8476",
            "fax_number": "540-869-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION FUNCTIONAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-247-8476",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Mink
• Casey Marie Minor, FNP-BC
• Laura Minster
• Santiago Miro, B.S., M.D.
• Joseph M Misera, O.D.
• Wilson Tyler Mistr, DDS
• Elizabeth Colleen Mistretta
• Debra Mitchell, DIETIAN
• Kaylin Lintz Mitchell
• Kelly Ann Mitchell, PH.D.

• Family Medicine Physician in Winchester, VA
• Providers in Winchester, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.