MEDICAL MANAGEMENT OF VIRGINIA, LLC (NPI# 1245598085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245598085 |
| Entity Type | Organization |
| Organization Name | MEDICAL MANAGEMENT OF VIRGINIA, LLC |
| Other Organization Name | NATURAL HORIZONS WELLNESS CENTER |
| Practice Address |
11230 Waples Mill Rd Suite 125 Fairfax VA 22030-6087 |
| Practice Telephone | 7032469355 |
| Practice Fax Number | 7032676977 |
| Mailing Telephone | 7032469355 |
| Mailing Fax Number | 7032676977 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |
| Authorized Official Name | JOHN BUCKNER (BUSINESS ADMINISTRATOR) |
| Authorized Official Telephone | 7032469355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
VA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Natural Horizons Wellness Center | Doing Business As Name - Organization |
| Street Address |
11230 WAPLES MILL RD SUITE 125 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-6087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205805058 | Andrew Anthony Prishack | Physical Therapist | 11230 Waples Mill Rd, Suite 130, Fairfax, VA 22030-6087 | 2006-03-15 |
| 1942731153 | Aimee Evans | Speech-Language Pathologist | 11230 Waples Mill Rd, Fairfax, VA 22030-6087 | 2017-03-21 |
| 1497162093 | Laurie Loope Miller | Social Worker | 11230 Waples Mill Rd, Suite 100, Fairfax, VA 22030-6087 | 2014-07-15 |
| 1497186068 | Medical Management of Va | Dentist | 11230 Waples Mill Rd, Suite 125, Fairfax, VA 22030-6087 | 2013-12-09 |
| 1467884411 | Hannah Marie Ojard | Social Worker | 11230 Waples Mill Rd, Suite 100, Fairfax, VA 22030-6087 | 2013-08-01 |
| 1104078765 | Hallie E Fleisch | Social Worker | 11230 Waples Mill Rd, Fairfax, VA 22030-6087 | 2008-10-15 |
| 1750547063 | Meagan Konkol | Physical Therapist | 11230 Waples Mill Rd, Suite 130, Fairfax, VA 22030-6087 | 2008-08-06 |
| 1851551311 | Malvolia La Frances Gregory | Counselor | 11230 Waples Mill Rd, Suite 105, Fairfax, VA 22030-6087 | 2008-06-09 |
| 1710145461 | Jennifer Anne Shaw | Counselor | 11230 Waples Mill Rd, Suite 105, Fairfax, VA 22030-6087 | 2008-05-29 |
| 1235339466 | Sora Lee | Dentist | 11230 Waples Mill Rd, 160, Fairfax, VA 22030-6087 | 2007-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
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| 1114565298 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 12255 Fair Lakes Pkwy, Fairfax, VA 22033-3952 | 2019-12-19 |
| 1962946756 | Comprehensive Care Clinics | Clinic/Center | 3022 Williams Drive, Suite 100, Fairfax, VA 22031 | 2016-12-13 |
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| 1770191660 | Treasure Health Inc | Clinic/Center | 6000 Stevenson Ave Ste F, Alexandria, VA 22304-3563 | 2020-07-17 |
| 1003443359 | Henry A Mccleary Dc LLC | Clinic/Center | 2239c Tacketts Mill Dr, Woodbridge, VA 22192-3026 | 2020-03-26 |
| 1962044420 | Alice Tseng Od Optometrist Pllc | Clinic/Center | 6211 Leesburg Pike, Falls Church, VA 22044-2107 | 2019-10-16 |
| 1245897941 | Metropolitan Medical | Clinic/Center | 3046 Valley Ave Ste 100, Winchester, VA 22601-2679 | 2019-05-29 |
| 1942768692 | Medsquare LLC | Clinic/Center | 8575a Sudley Rd, Manassas, VA 20110-3811 | 2019-03-12 |
| 1770055410 | Caring Hearts Free Clinic of Patrick County | Clinic/Center | 835 Woodland Dr Ste 101, Stuart, VA 24171-1586 | 2018-12-19 |
| 1851863708 | Tu Family Clinic LLC | Clinic/Center | 2946 Sleepy Hollow Rd Ste B, Falls Church, VA 22044-2003 | 2018-12-17 |
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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.