Short Pump Wellness Clinic, LLC

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

Legal business name

SHORT PUMP WELLNESS CLINIC, LLC

Doing business as

Medi Weightloss

Practice address

11551 Nuckols Rd
Suite C
Glen Allen, VA 23059-5565

Phone

(804) 888-6800

NPI assigned

Aug 10, 2015

Last updated

Aug 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher K Currin

Title

Coo

Phone

(804) 717-5000

Specialties & licenses 1

Addresses

Other names 1

• Medi Weightloss Doing business as

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1407232770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BROWNS WAY RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149501",
            "telephone_number": "804-419-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD",
            "address_2": "SUITE C",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-888-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORT PUMP WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "CURRIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "804-717-5000"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi Weightloss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dawn Niccolucci Shearman, LCSW
• Chiara Dawn Shelton, LCSW
• Kristen Nicole Shelton, PA
• Laura Shibut
• Ann Lewis Shields, P.N.P.
• Yingshan Shyu, MS, DPT
• Siblings Residential LLC
• Jeffrey M Sicat, MD
• Crystal T. Silvester, LCSW
• Nancy Norman Simmons, NP

• Obesity Medicine (Family Medicine) Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Obesity Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.