Modern Richmond Endocrinology, LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

0101247055 Issued in VA

Legal business name

MODERN RICHMOND ENDOCRINOLOGY, LLC

Practice address

1467 Johnston Willis Dr
North Chesterfield, VA 23235-4730

Phone

(804) 267-6920

Fax

(804) 267-6921

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Leanza Liu, MDNPI 1215105135

Title

President

Phone

(804) 267-6920

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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

• Leanza Hui Liu, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • North Chesterfield, VA
  • NPI 1215105135
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1447614920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 JOHNSTON WILLIS DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-267-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 JOHNSTON WILLIS DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-267-6920",
            "fax_number": "804-267-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN RICHMOND ENDOCRINOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "LEANZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-267-6920",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101247055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE",
            "identifier": "0101247055",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.