SHORT PUMP WELLNESS CLINIC, LLC (NPI# 1407232770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407232770 |
| Entity Type | Organization |
| Organization Name | SHORT PUMP WELLNESS CLINIC, LLC |
| Other Organization Name | MEDI WEIGHTLOSS |
| Practice Address |
11551 Nuckols Rd Suite C Glen Allen VA 23059-5565 |
| Mailing Address |
230 Browns Way Rd Midlothian VA 23114-9501 |
| Practice Telephone | 8048886800 |
| Mailing Telephone | 8044199101 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |
| Authorized Official Name | CHRISTOPHER K CURRIN (COO) |
| Authorized Official Telephone | 8047175000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QB0002X |
Family Medicine Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Medi Weightloss | Doing Business As Name - Organization |
| Street Address |
11551 NUCKOLS RD SUITE C |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059-5565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255424206 | Keith Andrew Derco | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2006-10-02 |
| 1497382378 | Taylor Delaine Zuchowski | Dietitian, Registered | 11551 Nuckols Rd, Glen Allen, VA 23059-5565 | 2020-03-23 |
| 1316324726 | Christina Wical | Nurse Practitioner | 11551 Nuckols Rd, Suite C, Glen Allen, VA 23059-5565 | 2015-05-05 |
| 1417388588 | Associates In Pediatrics | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2013-11-27 |
| 1831459080 | Joanne Sylvia Lane | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2012-05-22 |
| 1871749655 | Respiratory Specialties Company Lc | Durable Medical Equipment & Medical Supplies | 11551 Nuckols Rd, Suite N, Glen Allen, VA 23059-5565 | 2008-08-13 |
| 1235320854 | Helen Habtemichael | Nurse Practitioner | 11551 Nuckols Rd, Suite C, Glen Allen, VA 23059-5565 | 2007-08-08 |
| 1841413184 | Dominion Behavioral Healthcare | Counselor | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2007-04-11 |
| 1225155781 | Associates In Pediatrics | Pediatrics | 11551 Nuckols Rd, Suite F, Glen Allen, VA 23059-5565 | 2007-03-22 |
| 1851422331 | Renita Walden Randolph | Dentist | 11551 Nuckols Rd, Suite A, Glen Allen, VA 23059-5565 | 2007-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| Taxonomy Code | 207QB0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Obesity Medicine |
| A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. |
| Notes: Source: American Board of Obesity Medicine, www.abom.org [7/1/2015: title and definition modified] Additional Resource: American Society of Bariatric Physicians, www.asbp.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457818221 | Bruce Lucero | Family Medicine | 7116 Bedstraw Ct, Springfield, VA 22152-3158 | 2019-02-27 |
| 1831620251 | Cavery Wellness of Woodbridge | Family Medicine | 14330 Gideon Dr, Woodbridge, VA 22192-4640 | 2017-03-27 |
| 1508212184 | Honest Medical Weight Loss LLC | Family Medicine | 4500 Southgate Pl Ste 200, Chantilly, VA 20151-1714 | 2016-05-12 |
| 1518155126 | Northern Virginia Area Bariatric Consultants | Family Medicine | 2010a Opitz Blvd, Woodbridge, VA 22191 | 2007-10-09 |
| 1598141863 | Midlothian Wellness Clinic, LLC | Family Medicine | 230 Browns Way Rd, Midlothian, VA 23114-9501 | 2015-08-10 |
| 1790100477 | Lansdowne Weightloss & Wellness LLC | Family Medicine | 19500 Sandridge Way, # 170, Leesburg, VA 20176-3688 | 2014-03-04 |
| 1770745903 | Nicanor C Sutingco | Family Medicine | 2214 Executive Dr, Ste. B, Hampton, VA 23666-6606 | 2008-06-29 |
| City | GLEN ALLEN |
| Zip Code | 23059 |
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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.