Boston Medical Group- Virginia, P.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

BOSTON MEDICAL GROUP- VIRGINIA, P.C.

Practice address

4216 King Street
Alexandria, VA 22302

Phone

(703) 845-7411

Fax

(703) 845-7409

NPI assigned

Apr 2, 2014

Last updated

Apr 2, 2014By 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

Mr. Tom L. Le, M.D.

Title

Medical Director

Phone

(818) 808-2828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1629496088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4216 KING STREET",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22302",
            "telephone_number": "703-845-7411",
            "fax_number": "703-845-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 KING STREET",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22302",
            "telephone_number": "703-845-7411",
            "fax_number": "703-845-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MEDICAL GROUP- VIRGINIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-808-2828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Borris, PT
• Linda Darnell Boruff, MSN CRNP
• Anita L Boss, PSYD
• Elizabeth Ann Bostick, LCSW
• Leontyne Bostick, FNP
• Natalie Both, MSW
• Olivia M Bottalico, MA
• Katherine Boucher
• Carla J Bouma, PT, DPT
• Amy Bourne, IBCLC

• Urology Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Urology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.