Perfect Storm

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

PERFECT STORM

Doing business as

PS Contouring

Practice address

6800 Fleetwood Rd Ste 110
MC Lean, VA 22101-3604

Phone

(703) 388-9073

NPI assigned

Aug 7, 2023

Organization subpart

No

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

Authorized official

Name

Monderray Blassingame

Title

Coo

Phone

(703) 388-9073

Specialties & licenses 3

Addresses

Other names 2

• PS Contouring Doing business as
• Perfect Storm Body Contouring Other name

Locations

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1376226456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 FLEETWOOD RD STE 110",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013604",
            "telephone_number": "703-388-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 FLEETWOOD RD STE 110",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013604",
            "telephone_number": "703-388-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT STORM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "BLASSINGAME",
        "authorized_official_first_name": "MONDERRAY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "703-388-9073"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PS Contouring",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perfect Storm Body Contouring",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberlyn Nicole Pena
• Kelly Pennock, COTA
• Robert Fitzgerald Pereddo, LPTA
• Aloysius C Pereira, MD
• Ella Peresechenski, MD
• Kimberly Ann Perks
• Perthera, Inc
• Peter D. Bruno, M.D., P.C.
• Jennifer Lewis Pfab, PT
• Cindy Pham, PA-C

• Nutritionist in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Nutritionist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.