Integrative Medicine & Wellness

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRATIVE MEDICINE & WELLNESS

Practice address

42029 Bushclover Terrace
Aldie, VA 20105

Phone

(571) 659-4316

Fax

(866) 611-2705

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Mariya Bourget, MDNPI 1477870541

Title

Owner

Phone

(571) 659-4316

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Mariya Bourget, M.D.

  • Internal Medicine Physician
  • Woodbridge, VA
  • NPI 1477870541
  NPD Authorized official

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1386423804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42029 BUSHCLOVER TERRACE",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "20105",
            "telephone_number": "571-659-4316",
            "fax_number": "866-611-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42029 BUSHCLOVER TERRACE",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "20105",
            "telephone_number": "571-659-4316",
            "fax_number": "866-611-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "BOURGET",
        "authorized_official_first_name": "MARIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-659-4316",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VV1662B",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Homestead Art Therapy & Counseling LLC
• James Francis Hopkins III, D.D.S.
• Jason Huddle, LPC-R
• Deborah Ice
• Hejab Imteyaz, M.D
• Integrative Wellness Specialists
• Hyejin Jang
• Abigail Janney, LPC-R
• Mariyam Jaradi
• McKenna Jepsen

• Internal Medicine Physician in Aldie, VA
• Providers in Aldie, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.