NMG Affiliate Practice I, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NMG AFFILIATE PRACTICE I, LLC

Doing business as

Novant Health UVA Health System Bristow Run Family Medicine

Practice address

14540 John Marshall Hwy
Suite 104
Gainesville, VA 20155-1691

Phone

(703) 753-9799

Fax

(703) 753-9792

NPI assigned

Aug 22, 2013

Organization subpart

No

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

Authorized official

Name

Geoffrey Gardner

Title

VP of Finance

Phone

(703) 753-9799

Specialties & licenses 1

Addresses

Other names 1

• Novant Health UVA Health System Bristow Run Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1295169605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "703-753-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 JOHN MARSHALL HWY",
            "address_2": "SUITE 104",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201551691",
            "telephone_number": "703-753-9799",
            "fax_number": "703-753-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-22",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "703-753-9799"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health UVA Health System Bristow Run Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Iris Y Newsome-Randall, FNP
• Winifred Ngeh
• Emerald Nguyen
• Linh K Nguyen
• Tina Gam Nguyen, DMD
• NMG Affiliate Practice I, LLC (Novant Health UVA Health System Olde Towne Pediatrics)
• Chimezie Nnoruka
• Lovena Noelsaint
• Bernadette E Noisette, MD
• Reanna Noor, LPC

• Family Medicine Physician in Gainesville, VA
• Providers in Gainesville, 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 Apr 6, 2016; 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.