Loudoun Internal and Lifestyle Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LOUDOUN INTERNAL AND LIFESTYLE MEDICINE LLC

Practice address

19415 Deerfield Ave Ste 210
Lansdowne, VA 20176-8471

Phone

(703) 967-3863

NPI assigned

Sep 30, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Gauthami Gondy, MD

Title

Owner

Phone

(703) 967-3863

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1396386447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41187 GRENATA PRESERVE PL",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201758716",
            "telephone_number": "571-600-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE STE 210",
            "city": "LANSDOWNE",
            "state": "VA",
            "postal_code": "201768471",
            "telephone_number": "703-967-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDOUN INTERNAL AND LIFESTYLE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "GONDY",
        "authorized_official_first_name": "GAUTHAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-967-3863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lansdowne, VA
• Providers in Lansdowne, 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 30, 2019; 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.