NMG AFFILIATE PRACTICE I, LLC (NPI# 1750813812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750813812 |
| Entity Type | Organization |
| Organization Name | NMG AFFILIATE PRACTICE I, LLC |
| Other Organization Name | NOVANT HEALTH UVA HEALTH SYSTEM LAKE MANASSAS OB/GYN |
| Practice Address |
480 Fletcher Dr Suite 3 Warrenton VA 20186-2185 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 5712613529 |
| Practice Fax Number | 7037535613 |
| Mailing Telephone | 5712613529 |
| Mailing Fax Number | 7037535613 |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |
| Authorized Official Name | GEOFFERY K GARDNER (VP OF FINANCE) |
| Authorized Official Telephone | 5712613529 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Novant Health UVA Health System Lake Manassas OB/GYN | 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 |
480 FLETCHER DR SUITE 3 |
| City | WARRENTON |
| State | VA |
| Zip Code | 20186-2185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164815262 | Carolina Medicorp Enterprises Inc | Family Medicine | 480 Fletcher Dr, Suite 3, Warrenton, VA 20186-2185 | 2015-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639708704 | Melissa A. Griffith Crooks | Social Worker | In Luck Counseling, LLC, 92 Main Street, Warrenton, VA 20186 | 2020-04-02 |
| 1255757506 | Wecare Pharmacy LLC | Pharmacy | 516 Fletcher Dr, Warrenton, VA 20186 | 2014-03-11 |
| 1497031975 | Blue Ridge Orthopaedic Associates, PC | Physician Assistant | 52 W. Shirley Ave., Warrenton, VA 20186 | 2011-10-27 |
| 1215213939 | Bassim Mousa | Pharmacist | 276 Lee Hwy, Warrenton, VA 20186 | 2011-10-26 |
| 1770868721 | Denise Leanne Glasser | Pharmacist | 276 West Lee Highway, Warrenton, VA 20186 | 2011-10-20 |
| 1003117607 | Elizabeth A Lowell | Pharmacist | 189 Old Lee Hwy, Warrenton, VA 20186 | 2010-11-12 |
| 1396045688 | Suong Thu Nguyen | Pharmacist | 189 Lee Hwy, Warrenton, VA 20186 | 2010-11-02 |
| 1174830921 | Natalia Lueck | Counselor | 28 Ashby St Suite G101, Warrenton, VA 20186 | 2010-08-31 |
| 1568604742 | Harris Teeter, LLC | Pharmacy | 530 Fletcher Dr., Warrenton, VA 20186 | 2009-04-02 |
| 1396998480 | Act Family Program | Community/Behavioral Health | 39 Garrett Street, Suite 109, Warrenton, VA 20186 | 2008-11-03 |
| Find all providers in zip 20186 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043356132 | Gina Campbell Moore | Obstetrics & Gynecology | 428 Hospital Drive, Warrenton, VA 20186-3026 | 2007-01-29 |
| 1437112513 | Lorraine Y Chun | Obstetrics & Gynecology | 400c Hospital Dr, Warrenton, VA 20186-3026 | 2006-04-10 |
| 1336118553 | Jeffrey Walton Bell | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2006-03-17 |
| 1104899624 | Wesley Raymond Hodgson | Obstetrics & Gynecology | 253 Veterans Dr, Suite 210, Warrenton, VA 20186-3076 | 2006-02-08 |
| 1952875809 | Nmg Affiliate Practice I, LLC | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2019-01-14 |
| 1467806422 | Elise Diamond | Obstetrics & Gynecology | 253 Veterans Dr, Warrenton, VA 20186-3076 | 2016-04-15 |
| 1437304599 | Thomas E. Myers, Md, PC | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2008-11-17 |
| 1740468560 | F John Bourgeois | Obstetrics & Gynecology | 75 W Lee Hwy, Warrenton, VA 20186-2149 | 2008-02-04 |
| 1457547994 | Commonwealth Obstetrics Gynecology PC | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2007-09-19 |
| 1750350930 | Thomas E Myers | Obstetrics & Gynecology | 428 Hospital Dr, Warrenton, VA 20186-3026 | 2006-03-17 |
| Find all providers in WARRENTON | ||||
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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.