NPIMap

Organization Active NPI

Medical Management of Virginia, LLC

Doing business as Natural Horizons Wellness Center

  • Health Service Clinic/Center
  • Fairfax, VA
National Provider Identifier
1245598085
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MEDICAL MANAGEMENT OF VIRGINIA, LLC
Doing business as
Natural Horizons Wellness Center
Practice address
11230 Waples Mill Rd
Suite 125
Fairfax, VA 22030-6087
Phone
(703) 246-9355
Fax
(703) 267-6977
NPI assigned
Apr 30, 2012
Last updated
Apr 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
John Buckner
Title
Business Administrator
Phone
(703) 246-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X VA Primary

Addresses

Primary practice location

11230 Waples Mill Rd
Suite 125
Fairfax, VA 22030-6087

Mailing address

11230 Waples Mill Rd
Suite 125
Fairfax, VA 22030-6087
Phone (703) 246-9355

Other names 1

  • Natural Horizons Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Horizons of Hope3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1245598085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 WAPLES MILL RD",
            "address_2": "SUITE 125",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306087",
            "telephone_number": "703-246-9355",
            "fax_number": "703-267-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 WAPLES MILL RD",
            "address_2": "SUITE 125",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306087",
            "telephone_number": "703-246-9355",
            "fax_number": "703-267-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MANAGEMENT OF VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "703-246-9355"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natural Horizons Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.