NMG AFFILIATE PRACTICE I, LLC (NPI# 1639618960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639618960 |
| Entity Type | Organization |
| Organization Name | NMG AFFILIATE PRACTICE I, LLC |
| Other Organization Name | NOVANT HEALTH UVA HEALTH SYSTEM INPATIENT CRITICAL CARE |
| Practice Address |
8700 Sudley Rd Manassas VA 20110-4418 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7033965292 |
| Mailing Telephone | 7033965292 |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | GEOFFREY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 7043847606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
0101231278 | NC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health UVA Health System Inpatient Critical Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639530124 | Nmg Affiliate Practice I, LLC | Internal Medicine | 4197c Winchester Rd, Marshall, VA 20115-3252 | 2016-03-11 |
| 1154701878 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8567 Sudley Rd Ste B, Manassas, VA 20110-3865 | 2015-06-08 |
| 1194110445 | Nmg Affiliate Practice I, LLC | Internal Medicine | 15195 Heathcote Blvd Suite 338, Haymarket, VA 20169-6242 | 2015-04-03 |
| 1831466440 | Nmg Affiliate Practice I, LLC | Surgery | 14010 Smoketown Rd Ste 105, Woodbridge, VA 22192-4723 | 2011-11-28 |
| 1770143570 | Nmg Affiliate Practice I, LLC | Surgery | 15195 Heathcote Blvd Ste 330, Haymarket, VA 20169-6244 | 2019-06-14 |
| 1487218871 | Nmg Affiliate Practice I, LLC | Family Medicine | 190 Moravian Way Dr, Winston Salem, NC 27106-3216 | 2019-05-01 |
| 1700440674 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-04-26 |
| 1780248823 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-04-24 |
| 1861056939 | Nmg Affiliate Practice I, LLC | Internal Medicine | 15225 Heathcote Blvd, Haymarket, VA 20169-6264 | 2019-04-24 |
| 1952875809 | Nmg Affiliate Practice I, LLC | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2019-01-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | NMG Affiliate Practice I, LLC | 2085 Frontis Plaza Blvd , Winston Salem, NC 27103-5614 |
| Virginia Business Entity | NMG AFFILIATE PRACTICE I, LLC | 200 HAWTHORNE LN , CHARLOTTE, NC 28204 |
| Street Address |
8700 SUDLEY RD |
| City | MANASSAS |
| State | VA |
| Zip Code | 20110-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770588725 | Christopher R Heaton | Family Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2005-06-16 |
| 1740806629 | Lyndsey Atherton Lee | Nurse Practitioner | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2020-06-17 |
| 1033731591 | Marti Abarquez | Radiologic Technologist | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2020-05-07 |
| 1235764317 | Chelsea Mara Thompson | Registered Nurse | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2020-03-09 |
| 1346874997 | Lauren Nichole-evans Jeske | Nurse Practitioner | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2020-02-22 |
| 1689218620 | Martha Gordon | Registered Nurse | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-11-02 |
| 1528609203 | Sheridan Childrens Healthcare Services of Virginia Inc | Audiologist | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-10-03 |
| 1700440674 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-04-26 |
| 1780248823 | Nmg Affiliate Practice I, LLC | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-04-24 |
| 1588122410 | Prince William Hospital | General Acute Care Hospital | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2019-03-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246787 | Sini Eapen | Nurse Practitioner | 9380 Forestwood Lane, 9380 Unit B, Manassas, VA 20110 | 2020-05-18 |
| 1023662202 | United Health Home Care Agency | Registered Nurse | 8789 Commerce Ct#202, Manassas, VA 20110 | 2019-07-26 |
| 1750868097 | Elaine K. Sours, D.d.s., P.C. | Dentist | 8719 Plantation Lane, Manassas, VA 20110 | 2018-07-19 |
| 1962904573 | Donielle Francis | Specialist/Technologist | 10420 Monterosa Pl, Manassas, VA 20110 | 2018-02-28 |
| 1003332354 | Katrina Kask | Occupational Therapist | 6985 Centreville Rd., Manassas, VA 20110 | 2017-08-18 |
| 1477091478 | Mega Health Services, Inc | General Practice | 9602 Champion Ct, Manassas, VA 20110 | 2017-02-09 |
| 1811340599 | Malik Usman Dds, PC | Dentist | 8559 Sudley Road, Manassas, VA 20110 | 2016-07-19 |
| 1871944660 | Chitra Subbaraj | Physical Therapist | 8595 Centreville Rd, Manassas, VA 20110 | 2016-06-23 |
| 1093186512 | Daczkowski Orthodontics | Dentist | 8715 Stonewall Road, Manassas, VA 20110 | 2015-10-09 |
| 1851770366 | Candace Fleming | Counselor | 9242b Mosby St, Manassas, VA 20110 | 2015-05-29 |
| Find all providers in zip 20110 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316290083 | Theresa Ann Ganoe | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110 | 2012-10-18 |
| 1467525261 | Joanne Ondrush | Internal Medicine | 8700 Sudley Rd, Manassas, VA 20110-4418 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920205 | Katelynn Suzanne Doeppe | Internal Medicine | 1401 Johnstn Wllis Dr, North Chesterfield, VA 23235-4730 | 2020-10-20 |
| 1104319698 | Capital Critical Care & Informatics PC | Internal Medicine | 11890 Sunrise Valley Dr # 442, Reston, VA 20191 | 2018-06-11 |
| 1417459058 | William A. Knaus | Internal Medicine | 1926 Lewis Mountain Rd, Charlottesville, VA 22903-2413 | 2018-02-28 |
| 1376043489 | Sentara Medical Group | Internal Medicine | 301 Riverview Ave Ste 670, Norfolk, VA 23510-1065 | 2018-02-15 |
| 1538684790 | Feras Ibrahim Hawari | Internal Medicine | 4714 Minor Cir, Alexandria, VA 22312 | 2017-08-09 |
| 1821474289 | Ravi Jagdish Patel | Internal Medicine | 6380 Homewood Cir, Roanoke, VA 24018-8308 | 2015-08-07 |
| 1538587761 | Gretchen Elder Brayman | Internal Medicine | 4000 Coliseum Dr Ste 320, Hampton, VA 23666-5983 | 2014-04-04 |
| 1235448911 | Anish S. Desai, Md, LLC | Internal Medicine | 8301 Arlington Blvd Ste T5, Fairfax, VA 22031-2904 | 2010-09-29 |
| 1982861795 | Yu Chi C Wang | Internal Medicine | 1625 N George Mason Dr Ste 355, Arlington, VA 22205-3690 | 2008-05-20 |
| 1134300148 | Arshan Beyzaei Arani | Internal Medicine | Commonwealth Critical Care 2501 Parkers Ln, Alexandria, VA 22334-4405 | 2007-11-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.