Organization Active NPI

Lifestyle Physicians LLC

  • Internal Medicine Physician
  • Reston, VA
National Provider Identifier
1881228021
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFESTYLE PHYSICIANS LLC
Practice address
12330 Pinecrest Rd Ste 125
Reston, VA 20191-1655
Phone
(540) 680-2426
NPI assigned
Feb 26, 2020
Organization subpart
Yes
Parent organization
LIFESTYLE PHYSICIANS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Sagar VermaNPI 1023266038
Title
MD
Phone
(540) 829-5773

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12330 Pinecrest Rd Ste 125
Reston, VA 20191-1655

Mailing address

147 Alexandria Pike Ste 104
Warrenton, VA 20186-2947
Phone (540) 680-2426

Other identifiers 1

IdentifierTypeStateIssuer
0101253031OtherVASTATE LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Lifestyle Physicians LLC2 organizations share this tax ID, including this one
Part of
Lifestyle Physicians LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1881228021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 ALEXANDRIA PIKE STE 104",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862947",
            "telephone_number": "540-680-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 PINECREST RD STE 125",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911655",
            "telephone_number": "540-680-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE PHYSICIANS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESTYLE PHYSICIANS LLC",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "SAGAR",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "540-829-5773"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0101253031",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.