Organization Active NPI

Northwest Internists LLC

  • Internal Medicine Physician
  • MC Lean, VA
National Provider Identifier
1770536724
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101038350 Issued in VA
Legal business name
NORTHWEST INTERNISTS LLC
Practice address
1313 Dolley Madison Blvd
Suite 302
MC Lean, VA 22101-3953
Phone
(703) 356-2037
Fax
(703) 734-8987
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Thomas M Masterson, MD
Title
Director
Phone
(703) 356-2037

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 0101038350 VA Primary

Addresses

Primary practice location

1313 Dolley Madison Blvd
Suite 302
MC Lean, VA 22101-3953

Mailing address

PO Box 487
MC Lean, VA 22101-0487
Phone (703) 356-2037

Other identifiers 1

IdentifierTypeStateIssuer
0101038350OtherVAMEDICAL LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1770536724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221010487",
            "telephone_number": "703-356-2037",
            "fax_number": "703-734-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 DOLLEY MADISON BLVD",
            "address_2": "SUITE 302",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013953",
            "telephone_number": "703-356-2037",
            "fax_number": "703-734-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INTERNISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-356-2037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101038350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "0101038350",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.