NMG Affiliate Practice I, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

NMG AFFILIATE PRACTICE I, LLC

Doing business as

Novant Health UVA Health System Urgent Care & Occupational Medicine

Practice address

6208 Multiplex Dr
Suite 150
Centreville, VA 20121-5324

Phone

(703) 366-2590

Fax

(703) 366-2591

NPI assigned

Jul 13, 2016

Last updated

Jul 29, 2016By 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

Geoffrey K Gardner

Title

VP of Finance

Phone

(703) 366-2590

Specialties & licenses 2

Addresses

Other names 1

• Novant Health UVA Health System Urgent Care & Occupational Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Uva Community Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Charlottesville, VA
  • NPI 1598475741

  O20150723007128

  Same enrollment
• Uva Community Health Medical Group, LLC

  dba Novant Health Prince William Cardiology Warrenton

  • Cardiovascular Disease Physician
  • Falls Church, VA
  • NPI 1780065656

  O20150723007128

  Same enrollment

Locations

Practitioners 2

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.

• Oladunni Ayanru

  • Nurse Practitioner
  • Haymarket, VA
  • NPI 1790291136
  NPD
• Ermias Aytenfisu Mekonnen, M.D.

  • Neurology Physician
  • Bethesda, MD
  • NPI 1346436276

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469750400000",
    "number": "1881046993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 MULTIPLEX DR",
            "address_2": "SUITE 150",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201215324",
            "telephone_number": "703-366-2590",
            "fax_number": "703-366-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NMG AFFILIATE PRACTICE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "703-366-2590"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health UVA Health System Urgent Care & Occupational Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doantrang T Nguyen, DDS
• Jennifer Caspers Nguyen, DDS
• Katelyn Nguyen, PHARMD
• Linhlan Cao Nguyen, PHARMD
• Sandor Shawn Niemann, MD
• NMS Transit Services Inc (Metro Med)
• NMS Transit Services Inc. (Metro Med)
• Uyanga Calvo Nomingerel, FNP-BC
• Shirlea North, PT, DPT
• Northern Oaks Family Services LLC

• Emergency Medicine Physician in Centreville, VA
• Providers in Centreville, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.