Organization Active NPI

Integrated Wellness & Weightloss Center LLC

  • General Practice Physician
  • Fairfax, VA
National Provider Identifier
1417879974
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INTEGRATED WELLNESS & WEIGHTLOSS CENTER LLC
Practice address
9629 Fairfax Blvd Ste 211
Fairfax, VA 22031-2321
Phone
(571) 435-0186
NPI assigned
Jul 28, 2026
Last updated
Jul 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Jeddie Garcia, DNP, APN, FNP-CNPI 1457925364
Title
FNP
Phone
(973) 978-0174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

9629 Fairfax Blvd Ste 211
Fairfax, VA 22031-2321

Mailing address

26081 Wendell St
Chantilly, VA 20152-3403
Phone (571) 435-0186

National Provider Directory

National Provider Directory

Locations

9629 Fairfax Blvd
Ste 211
Fairfax, VA 22031

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1785196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1417879974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26081 WENDELL ST",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201523403",
            "telephone_number": "571-435-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9629 FAIRFAX BLVD STE 211",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312321",
            "telephone_number": "571-435-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED WELLNESS & WEIGHTLOSS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-28",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JEDDIE",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "973-978-0174",
        "authorized_official_credential": "DNP, APN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.