NPIMap

Organization Active NPI

Internal Medicine of Stafford

  • Internal Medicine Physician
  • Stafford, VA
National Provider Identifier
1972538817
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101045978 Issued in VA
Legal business name
INTERNAL MEDICINE OF STAFFORD
Practice address
422 Garrisonville Rd
Suite 108
Stafford, VA 22554-1573
Phone
(540) 658-9340
Fax
(540) 658-9344
NPI assigned
Jul 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nibedita Mohanty, M.D.NPI 1801847413
Title
Physician/Owner
Phone
(540) 658-9340

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 Physician 207R00000X 0101045978 VA Primary

Addresses

Primary practice location

422 Garrisonville Rd
Suite 108
Stafford, VA 22554-1573

Mailing address

422 Garrisonville Rd
Suite 108
Stafford, VA 22554-1573
Phone (540) 658-9340

National Provider Directory

National Provider Directory

Locations

422 Garrisonville Rd
Ste 108
Stafford, VA 22554
Phone (540) 658-9340

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972538817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 GARRISONVILLE RD",
            "address_2": "SUITE 108",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541573",
            "telephone_number": "540-658-9340",
            "fax_number": "540-658-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 GARRISONVILLE RD",
            "address_2": "SUITE 108",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541573",
            "telephone_number": "540-658-9340",
            "fax_number": "540-658-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF STAFFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOHANTY",
        "authorized_official_first_name": "NIBEDITA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "540-658-9340",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101045978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.