Vivis Family Medicine LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VIVIS FAMILY MEDICINE LLC

Practice address

3606 Chancelsors Dr
Upper Marlboro, MD 20772-8194

Phone

(240) 605-5215

NPI assigned

Sep 23, 2024

Organization subpart

No

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

Authorized official

Name

Hedwig E Manga WilliamsNPI 1487098521

Title

Owner

Phone

(240) 605-5215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vivis Family Medicine LLC

  • Primary Care Clinic/Center
  • Upper Marlboro, MD
  • NPI 1174237200

  O20230215002459

  Same enrollment

Tax ID family

Vivis Family Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Vivis Family Medicine LLC

  • Primary Care Clinic/Center
  • Upper Marlboro, MD
  • NPI 1174237200
  NPD tax ID

Practitioners 2

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.

• Hedwig E Manga Williams, NP-C

  • Family Nurse Practitioner
  • Laurel, MD
  • NPI 1487098521
  Authorized official Same address or phone
• Charles Besong, RN, DNP, MSN, FNP-BC

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1720432172
  NPD

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1346067220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 CHANCELSORS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728194",
            "telephone_number": "240-605-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 CHANCELSORS DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728194",
            "telephone_number": "240-605-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIS FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "MANGA WILLIAMS",
        "authorized_official_first_name": "HEDWIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-605-5215"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visionary Medical & Mental Healthcare, Inc.
• Visionary Medical & Mental Healthcare, Inc.
• Visionary Professional Healthcare Services
• Vital Hands Rehab LLC
• Vivis Family Medicine LLC
• Voice of Hope Behavioral Health LLC
• Vyne Infusions LLC
• W2 Inc (W2 Logistics)
• Walgreen Co (Walgreens #19492)
• Walgreen Co. (Walgreens #19492)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.