NPIMap

Organization Active NPI

NMG Affiliate Practice I, LLC

Doing business as Novant Health UVA Health SystemDiabetes & Nutrition Manassas

  • Internal Medicine Physician
  • Manassas, VA
National Provider Identifier
1427650340
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NMG AFFILIATE PRACTICE I, LLC
Doing business as
Novant Health UVA Health SystemDiabetes & Nutrition Manassas
Practice address
8644 Sudley Rd Ste 315
Manassas, VA 20110-4425
Phone
(703) 369-8405
NPI assigned
Nov 16, 2020
Last updated
Nov 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
NMG AFFILIATE PRACTICE I, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Shala Davis
Title
Enrollment Mnaager
Phone
(704) 316-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

8644 Sudley Rd Ste 315
Manassas, VA 20110-4425

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health UVA Health SystemDiabetes & Nutrition Manassas Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Uva Community Health Medical Group LLC42 organizations share this tax ID, including this one
Part of
Uva Community Health Medical Group LLC

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

8644 Sudley Rd
Ste 315
Manassas, VA 20110
Phone (703) 369-8055

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1427650340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD STE 315",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104425",
            "telephone_number": "703-369-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NMG AFFILIATE PRACTICE I, LLC",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "ENROLLMENT MNAAGER",
        "authorized_official_telephone_number": "704-316-7845"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health UVA Health SystemDiabetes & Nutrition Manassas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.