Organization Active NPI

Foundations Integrated Medical & Sports Health, LLC

  • General Practice Physician
  • Bristol, VA
National Provider Identifier
1770115578
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FOUNDATIONS INTEGRATED MEDICAL & SPORTS HEALTH, LLC
Practice address
300 Moore St Ste B
Bristol, VA 24201-4495
Phone
(276) 591-5448
Fax
(276) 591-5447
NPI assigned
Feb 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Dr. Thomas L Muncy II, DCNPI 1306861984
Title
Owner
Phone
(276) 591-5448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

300 Moore St Ste B
Bristol, VA 24201-4495

Mailing address

300 Moore St Ste B
Bristol, VA 24201-4495
Phone (276) 591-5448

National Provider Directory

National Provider Directory

Locations

300 Moore St
Ste B
Bristol, VA 24201
Phone (276) 591-5448

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1770115578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOORE ST STE B",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242014495",
            "telephone_number": "276-591-5448",
            "fax_number": "276-591-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOORE ST STE B",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242014495",
            "telephone_number": "276-591-5448",
            "fax_number": "276-591-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS INTEGRATED MEDICAL & SPORTS HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MUNCY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-591-5448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

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