Organization Active NPI

Mosaic Medical Group, LLC

  • General Practice Physician
  • Manassas, VA
National Provider Identifier
1356671457
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MOSAIC MEDICAL GROUP, LLC
Practice address
8525 Rolling Rd
Suite 222
Manassas, VA 20110-3647
Phone
(703) 393-0720
Fax
(703) 334-0750
NPI assigned
Jan 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Holly North
Title
Office Manager
Phone
(703) 393-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

8525 Rolling Rd
Suite 222
Manassas, VA 20110-3647

Mailing address

8525 Rolling Rd
Suite 220
Manassas, VA 20110-3647
Phone (703) 393-0700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1356671457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 ROLLING RD",
            "address_2": "SUITE 220",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103647",
            "telephone_number": "703-393-0700",
            "fax_number": "703-393-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 ROLLING RD",
            "address_2": "SUITE 222",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201103647",
            "telephone_number": "703-393-0720",
            "fax_number": "703-334-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "NORTH",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-393-0700"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.