Integrative Hyperbaric & Wound Care LLC

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

INTEGRATIVE HYPERBARIC & WOUND CARE LLC

Practice address

410 Pine St SE
Suite 330
Vienna, VA 22180-4861

Phone

(703) 938-1421

Fax

(703) 938-1424

NPI assigned

Apr 10, 2015

Organization subpart

Yes

Parent organization

VIRGINIA FUNCTIONAL MEDICINE INCAs reported in NPPES

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

Authorized official

Name

Calista Petrie

Title

Case Manager

Phone

(703) 938-1421

Specialties & licenses 4

Addresses

Part of

Virginia Functional Medicine Inc

Locations

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.

• Virginia Functional Medicine, Inc

  • Internal Medicine Physician
  • Vienna, VA
  • NPI 1194011783
  NPPES parent name

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1922494459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE",
            "address_2": "SUITE 330",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-938-1421",
            "fax_number": "703-938-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PINE ST SE",
            "address_2": "SUITE 330",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804861",
            "telephone_number": "703-938-1421",
            "fax_number": "703-938-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE HYPERBARIC & WOUND CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIRGINIA FUNCTIONAL MEDICINE INC",
        "enumeration_date": "2015-04-10",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "CALISTA",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "703-938-1421"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Vienna, VA
• Providers in Vienna, VA by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.