SHANGRI-LA INTEGRATED CLINIC (NPI# 1336707553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336707553 |
| Entity Type | Organization |
| Organization Name | SHANGRI-LA INTEGRATED CLINIC |
| Practice Address |
13890 Braddock Rd Ste 300 Centreville VA 20121-2438 |
| Practice Telephone | 5716552281 |
| Mailing Telephone | 5716552281 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | CHUNG DO KIM (DIRECTOR) |
| Authorized Official Telephone | 5712182393 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | N/A | 0121000910 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Shangri-La Integrated Clinic PC | 13890 Braddock Road Suite 300, Centreville, Virginia 20121 |
| Street Address |
13890 BRADDOCK RD STE 300 |
| City | CENTREVILLE |
| State | VA |
| Zip Code | 20121-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114480548 | Young Su Kim | Acupuncturist | 13890 Braddock Rd Ste 300, Centreville, VA 20121-2438 | 2019-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356906994 | Everyone Inc. | Durable Medical Equipment & Medical Supplies | 6362 James Harris Way, Centreville, VA 20121 | 2019-05-09 |
| 1154845139 | Dien Tu | Pharmacist | 6321 Powder Flask Ct., Centreville, VA 20121 | 2017-08-01 |
| 1053865337 | Chungkang Pharmacy, LLC | Pharmacy | 14637 Lee Highway, #109b, Centreville, VA 20121 | 2016-08-04 |
| 1265829808 | Trisha Yamamoto | Chiropractor | 14215 E. Centreville Square, Centreville, VA 20121 | 2015-04-21 |
| 1811305733 | Catherine Elizabeth Sims, LLC | Clinic/Center | 6705 Bay Valley Lane, Centreville, VA 20121 | 2014-07-23 |
| 1194138438 | All In A Day Senior Care Services.com | Home Health | 6913 Confederate Ridge Lane, Centerville, VA 20121 | 2014-06-04 |
| 1447519483 | James Hamilton | Occupational Therapy Assistant | 6220 William Mosby Dr, Centreville, VA 20121 | 2012-05-11 |
| 1609158674 | Rena Thuman | Dentist | 14245-f Centreville Square, Centreville, VA 20121 | 2011-09-15 |
| 1134426372 | One Stop Pharmacy Inc | Pharmacy | 13818-b Braddock Rd, Centreville, VA 20121 | 2011-02-24 |
| 1225267495 | Michael Andrew Hartman | Family Medicine | 6201 Centerville Rd, # 100, Centreville, VA 20121 | 2009-07-09 |
| Find all providers in zip 20121 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992142335 | Turner Chiropractic Clinic of Centreville | Clinic/Center | 13880 Braddock Rd, Suite 106, Centreville, VA 20121-2459 | 2013-05-24 |
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|---|---|---|---|---|
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| 1831711902 | Charlottesville Hyperbarics Corp | Clinic/Center | 925-a E Jefferson St, Charlottesville, VA 22902-5573 | 2020-05-12 |
| 1417579889 | Health Bridge, LLC | Clinic/Center | 4198 Cox Rd Ste 102, Glen Allen, VA 23060-3328 | 2020-05-08 |
| 1851924088 | First Light Clinic LLC | Clinic/Center | 706 Campbell Ave Sw, Roanoke, VA 24016-3534 | 2020-02-17 |
| 1912537440 | B's Integrated Clinic, Pllc | Clinic/Center | 501 Rison St Ste 100, Danville, VA 24541-2426 | 2020-01-23 |
| 1770122723 | Colonial Beach Health & Wellness Inc | Clinic/Center | 700 Mckinney Blvd Ste 1100, Colonial Beach, VA 22443-1934 | 2019-12-21 |
| 1104461896 | Lung Specialists of Tidewater Pllc | Clinic/Center | 224 Avonlea Pointe, Chesapeake, VA 23322-4279 | 2019-11-17 |
| 1053952846 | Mediluxe | Clinic/Center | 19349 Diamond Lake Dr, Leesburg, VA 20176-6596 | 2019-10-02 |
| 1720639503 | Javan Wellness Ballston LLC | Clinic/Center | 4000 Wilson Blvd Ste D, Arlington, VA 22203-4401 | 2019-09-24 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 20121 |
Please comment or provide details below to improve the information on SHANGRI-LA INTEGRATED CLINIC.
| 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.