Mystreethealth Limited Liability Company

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MYSTREETHEALTH LIMITED LIABILITY COMPANY

Doing business as

Mystreethealth

Practice address

1535 Wilson Blvd
Arlington, VA 22209-2433

Phone

(888) 835-9995

NPI assigned

Jun 19, 2019

Last updated

May 8, 2023By 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

N Elias

Title

Administrator

Phone

(703) 688-2222

Specialties & licenses 1

Addresses

Other names 1

• MYSTREETHEALTH Doing business as

Locations

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.

• Nnemdi Kamanu Elias, M.D.

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1538369830
  NPD

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1548820780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 PENNSYLVANIA AVE NW # 131",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 WILSON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092433",
            "telephone_number": "888-835-9995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Campus View Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432354647",
            "country_code": "US",
            "telephone_number": "888-835-9995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Wisconsin Cir",
            "address_purpose": "LOCATION",
            "city": "Chevy Chase",
            "state": "MD",
            "postal_code": "208157003",
            "country_code": "US",
            "telephone_number": "888-835-9995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 Campus Blvd",
            "address_purpose": "LOCATION",
            "city": "Newtown Square",
            "state": "PA",
            "postal_code": "190733245",
            "country_code": "US",
            "telephone_number": "888-835-9995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Westerre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232331478",
            "country_code": "US",
            "telephone_number": "888-835-9995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8200 Greensboro Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221023892",
            "country_code": "US",
            "telephone_number": "703-688-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYSTREETHEALTH LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-688-2222"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MYSTREETHEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MYSTREETHEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trevor Perrin Myers, M.D
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• Clinic/Center in Arlington, VA
• Providers in Arlington, VA by specialty
• Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.