Physicians Premiere Weight & Wellness Center, P.L.L.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIANS PREMIERE WEIGHT & WELLNESS CENTER, P.L.L.C.

Practice address

25055 Riding PLZ Ste 230
Chantilly, VA 20152-5920

Phone

(703) 783-5673

Fax

(703) 297-8100

NPI assigned

Jun 20, 2019

Organization subpart

No

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

Authorized official

Name

Kari Tissandier

Title

Office Manager

Phone

(757) 406-6645

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1952961989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23289 MEADOWVALE GLEN CT",
            "city": "DULLES",
            "state": "VA",
            "postal_code": "201662151",
            "telephone_number": "703-783-5673",
            "fax_number": "703-297-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 230",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525920",
            "telephone_number": "703-783-5673",
            "fax_number": "703-297-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS PREMIERE WEIGHT & WELLNESS CENTER, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "TISSANDIER",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-406-6645"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.