Longevite Health and Wellness

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LONGEVITE HEALTH AND WELLNESS

Practice address

14024 Wiley Cir
Midlothian, VA 23114-5578

Phone

(804) 639-8145

Fax

(804) 818-2637

NPI assigned

Dec 18, 2018

Last updated

Nov 13, 2022By 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

Dr. Bernice Natalie Mucius-Penha, MDNPI 1568628527

Title

Physician

Phone

(516) 673-8554

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13965/brand/1/csg/1/fhir/r4

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.

• Bernice Natalie Mucius-Penha, M.D.

  • Family Medicine Physician
  • Midlothian, VA
  • NPI 1568628527
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668297600000",
    "number": "1730651589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14024 WILEY CIR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231145578",
            "telephone_number": "804-639-8145",
            "fax_number": "804-818-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14024 WILEY CIR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231145578",
            "telephone_number": "804-639-8145",
            "fax_number": "804-818-2637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6055 Harbour Park Dr",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231122160",
            "country_code": "US",
            "telephone_number": "804-639-8145",
            "fax_number": "804-818-2637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONGEVITE HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-18",
        "last_updated": "2022-11-13",
        "certification_date": "2022-11-13",
        "status": "A",
        "authorized_official_last_name": "MUCIUS-PENHA",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_middle_name": "NATALIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "516-673-8554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Usry Locher, LPC
• Gretchen D Lockard, M.D.
• Sebastian Richard Lodwick
• Kathryn Marie Logsdon, MPT
• Allison Marie Longest, MSN, AGACNP-BC
• Samuel James Longo, PT, DPT
• Yaquelin Lopez Garcia, DPT
• Keisha Ronnelle Lopez, NP
• Shelli Clemens Lord-Pawson, PEERRECOVERYSPECIALI
• Clay Ashley Loucks, MD

• Family Medicine Physician in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2022; 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.