NPIMap

Organization Active NPI

Mediko, PC

  • Psychiatry Physician
  • Glen Allen, VA
National Provider Identifier
1659658805
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MEDIKO, PC
Practice address
301 Concourse Blvd
Suite 210
Glen Allen, VA 23059-5643
Phone
(804) 433-1010
Fax
(804) 433-1055
NPI assigned
Nov 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Dr. Kaveh Ofogh, M.D.
Title
President
Phone
(804) 433-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X VA Primary

Addresses

Primary practice location

301 Concourse Blvd
Suite 210
Glen Allen, VA 23059-5643

Mailing address

301 Concourse Blvd
Suite 210
Glen Allen, VA 23059-5643
Phone (804) 433-1010

National Provider Directory

National Provider Directory

Locations

301 Concourse Blvd
Ste 210
Glen Allen, VA 23059
Phone (804) 433-1041

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1659658805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CONCOURSE BLVD",
            "address_2": "SUITE 210",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595643",
            "telephone_number": "804-433-1010",
            "fax_number": "804-433-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CONCOURSE BLVD",
            "address_2": "SUITE 210",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595643",
            "telephone_number": "804-433-1010",
            "fax_number": "804-433-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIKO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "OFOGH",
        "authorized_official_first_name": "KAVEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-433-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.