Organization Active NPI

Virginia Integrative Medical LLC

  • Health Service Clinic/Center
  • Winchester, VA
National Provider Identifier
1982061297
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
0104556472 Issued in VA
Legal business name
VIRGINIA INTEGRATIVE MEDICAL LLC
Doing business as
Virginia Integrative Medical LLC
Practice address
125 Prosperity Dr
Suite 500
Winchester, VA 22602-5385
Phone
(540) 550-3656
Fax
(540) 868-0166
NPI assigned
Jan 19, 2016
Last updated
Jan 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Dr. Abel Costas Borromeo V, DCNPI 1174572283
Title
Managing Member
Phone
(540) 550-3656

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
Health Service Clinic/Center 261QH0100X 0104556472 VA Primary

Addresses

Primary practice location

125 Prosperity Dr
Suite 500
Winchester, VA 22602-5385

Mailing address

125 Prosperity Dr
Suite 500
Winchester, VA 22602-5385
Phone (540) 550-3656

Other names 1

  • Virginia Integrative Medical LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1982061297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PROSPERITY DR",
            "address_2": "SUITE 500",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226025385",
            "telephone_number": "540-550-3656",
            "fax_number": "540-868-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PROSPERITY DR",
            "address_2": "SUITE 500",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226025385",
            "telephone_number": "540-550-3656",
            "fax_number": "540-868-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA INTEGRATIVE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "BORROMEO",
        "authorized_official_first_name": "ABEL",
        "authorized_official_middle_name": "COSTAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "540-550-3656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "V",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "VA",
            "license": "0104556472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Integrative Medical LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.