Integrative Medicine & Wellness Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRATIVE MEDICINE & WELLNESS INC

Practice address

7900 Sudley Rd Ste 416
Manassas, VA 20109-2806

Phone

(703) 563-3804

Fax

(877) 409-1647

NPI assigned

Nov 19, 2024

Organization subpart

No

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

Authorized official

Name

Mariya Bourget, MDNPI 1477870541

Title

Owner

Phone

(703) 863-3029

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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

• Mariya Bourget, M.D.

  • Internal Medicine Physician
  • Woodbridge, VA
  • NPI 1477870541
  Medicare reassignment NPD Authorized official
• Rene Lynn Ernest, RN, ANP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1013071018
  Medicare reassignment NPD

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1619792256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 SUDLEY RD STE 416",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092806",
            "telephone_number": "703-563-3804",
            "fax_number": "866-611-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 SUDLEY RD STE 416",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092806",
            "telephone_number": "703-563-3804",
            "fax_number": "877-409-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE & WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "BOURGET",
        "authorized_official_first_name": "MARIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-863-3029",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Janelle Tatiana Irizarry, APRN, AGNP
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• Internal Medicine Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.