NMG Affiliate Practice I, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NMG AFFILIATE PRACTICE I, LLC

Practice address

14010 Smoketown Rd Ste 105
Woodbridge, VA 22192-4723

Phone

(703) 730-4848

Fax

(703) 730-7236

NPI assigned

Nov 28, 2011

Organization subpart

No

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

Authorized official

Name

Shala Davis

Title

RCS Manager

Phone

(704) 303-7517

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• UVA Breast Surgery Woodbridge Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

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

• Imran Akram, MD

  • Psychiatry Physician
  • Reston, VA
  • NPI 1053449389
  NPD

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1831466440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936952",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 SMOKETOWN RD STE 105",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924723",
            "telephone_number": "703-730-4848",
            "fax_number": "703-730-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHALA",
        "authorized_official_title_or_position": "RCS MANAGER",
        "authorized_official_telephone_number": "704-303-7517"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831466440",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UVA Breast Surgery Woodbridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raymond R. Niles II, DDS
• Nimos Light LLC
• Leigh Ann Nitz, CPM, LM
• NMG Affiliate Practice I, LLC
• NMG Affiliate Practice I, LLC
• Noah'S Arch LLC
• Noble Medical and Psychiatric Mental Health Services LLC
• Aldrin Noces
• Andrea Patricia Draghia Noonan, AG-ACNP
• Rizwana Noor, DDS

• Surgery Physician in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.