MIND BRIDGE CENTER LLC (NPI# 1790304616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790304616 |
| Entity Type | Organization |
| Organization Name | MIND BRIDGE CENTER LLC |
| Practice Address |
1390 Chain Bridge Rd # 10033 Mc Lean VA 22101-3904 |
| Practice Telephone | 5717668107 |
| Mailing Telephone | 5717668107 |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2020-04-10 |
| Authorized Official Name | DR. KURWA NYIGU (CEO) |
| Authorized Official Telephone | 3366247164 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | MIND BRIDGE CENTER LLC | 1390 Chain Bridge Rd #10033, Mclean, Virginia 22101 |
| Street Address |
1390 CHAIN BRIDGE RD # 10033 |
| City | MC LEAN |
| State | VA |
| Zip Code | 22101-3904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452630 | Kyle Rose | Counselor | 1360 Beverly Road, Suite 200, Mclean, VA 22101 | 2020-03-16 |
| 1760036206 | Chesapeake Eye Care & Laser Center LLC | Ophthalmology | 6845 Elm Street Ste 250, Mclean, VA 22101 | 2019-08-01 |
| 1326691759 | Vansay Vorrasane | Physical Therapist | 1735 Kirby Road, Mclean, VA 22101 | 2019-07-24 |
| 1912464025 | Veronica Martinez | Occupational Therapist | 1735 Kirby Rd., Mclean, VA 22101 | 2019-02-25 |
| 1114409547 | Katia Julio Salomao | Behavior Technician | 1651 Old Meadow Rd Suite 600, Mclean, VA 22101 | 2018-09-01 |
| 1871086157 | Steeple Run Associates, LLC | In Home Supportive Care | 1499 Chain Bridge Road, Suite 203-a, Mclean, VA 22101 | 2018-06-11 |
| 1982110565 | Jennifer Gallagher Munroe | Counselor | 1485 Chain Bridge Rd Ste 300, Mc Lean, VA 22101 | 2017-12-19 |
| 1497272553 | Alireza Aram | Dentist | 8421 Broad Street, Ste 1319, Mclean, VA 22101 | 2017-08-29 |
| 1104347962 | Louise Parry | Social Worker | 1491 Chain Bridge Road #300, Weaver and Associates, Mclean, VA 22101 | 2017-07-03 |
| 1366979361 | Anita Kathleen Bryce | Social Worker | 1364 Beverly Road, #304, Mclean, VA 22101 | 2017-05-22 |
| Find all providers in zip 22101 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053945428 | Radical Recovery Treatment Center Inc | Internal Medicine | 5040 Virginia Beach Blvd Ste 104, Virginia Beach, VA 23462-6637 | 2020-02-25 |
| 1245789460 | Nova Addiction Specialists Lllc | Internal Medicine | 101 N Columbus St, Suite 405, Alexandria, VA 22314-3056 | 2016-09-29 |
| 1184791725 | Alta J. Deroo | Internal Medicine | 767 Madison Rd Ste 107, Culpeper, VA 22701 | 2006-11-29 |
| 1881639375 | Sergey Zhitar | Internal Medicine | 101 N Lynnhaven Rd, Suite 100, Virginia Beach, VA 23452-7523 | 2006-06-18 |
| 1295724888 | Farook A. Shaikh | Internal Medicine | 6305 Castle Pl, Suite 3c, Falls Church, VA 22044-1905 | 2005-10-17 |
| 1992790406 | Jann L Holwick | Internal Medicine | 2609 Sheffield Dr Ste 100, Blacksburg, VA 24060-8271 | 2005-09-12 |
| 1972120483 | Global Health Services | Internal Medicine | 6395 Little River Tpke, Alexandria, VA 22312-5003 | 2020-06-30 |
| 1932554953 | Lotus Health, LLC | Internal Medicine | 2300 Dumbarton Rd, Richmond, VA 23228-6014 | 2016-04-27 |
| 1669858635 | Legacy Health Management Solutions | Internal Medicine | 5206 Markel Rd, Suite 102, Richmond, VA 23230-3044 | 2015-07-31 |
| 1710305990 | Radhika A Manhapra Md Pllc | Internal Medicine | 4509 Whitechapel Dr, Virginia Beach, VA 23455-6447 | 2014-04-03 |
| Find all providers with the same taxonomy | ||||
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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.