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1033500079 NPI Number Info

healthcare provider npi status:  active since 02/12/2015

MEDGEN URGENT CARE VIRGINIA LLC

Most Relevant Information

Provider Data

NPI Number 1033500079
Organization Name MEDGEN URGENT CARE VIRGINIA LLC
Entity Type Organization

Most Important Dates

Provider Enumeration Date 02/12/2015
Last Updated 04/10/2019

Provider Practice Location

3117 DUKE ST
ALEXANDRIA
VA
22314-4518
US

Practice Location Phone/Fax

Phone 703-751-8800
Fax  

Provider Mailing Address

6841 ELM ST #916
MC LEAN
VA
22101-0916
US

Mailing Location Phone/Fax

Phone 202-258-1627
Fax 844-213-1098

Authorized Official

Title or Position PART OWNER
Authorized Official Name CLELIA WALTERS
Credentials N/S  
Telephone Number 202-258-1627
Is it your NPI number ?

Detailed Information

NPI Number 1033500079 has the "Organization" type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — MEDGEN URGENT CARE VIRGINIA LLC.

The enumeration date of this NPI Number is 02/12/2015.
NPI Number information was last time updated on 04/10/2019.

The provider is physically located at:

3117 DUKE ST
ALEXANDRIA, VA
22314-4518, US

MEDGEN URGENT CARE VIRGINIA LLC can be reached at the following phone number(s):

Phone:  703-751-8800
Fax:  

The provider's official mailing address is:

6841 ELM ST #916
MC LEAN, VA
22101-0916, US

The contact numbers associated with the mailing address are:

Phone:  202-258-1627
Fax:  844-213-1098

The authorized official registered with the 1033500079 NPI Number is CLELIA WALTERS.

The authorized official title (position) is PART OWNER.

You can reach the authorized official at the following phone number 202-258-1627.

Scope of Practice (Taxonomy)

# Primary Taxonomy Code Taxonomy Specialty License Number License State
1 Y 261QU0200X Urgent Care Clinic/Center

Legacy (Non-NPI) Identifiers

(For crosswalk purposes, the following (non-NPI) identifiers are available for this provider)

# Provider Identifier Identifier Type Identifier State Issuer

Legacy & Proprietary Identifiers Ever Reported To NPPES

(Collection of legacy and proprietary (non-NPI) identifiers ever reported for this provider)

# Provider Identifier Identifier Type Identifier State Issuer

Reference NPI Information. Full Replica of the CMS (NPPES) NPI Record

Field Name Field Value
NPI 1033500079
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Organization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization Subpart Y
The "Is the organization a subpart?" question must be answered. If the organization is a subpart = , the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don't know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Parent Organization LBN MEDGEN URGENT CARE LLC
If the organization is a subpart, the Parent Organization Legal Business Name (LBN) field must be completed. The Parent Organization LBN field can only be completed if the answer to the subpart question is Yes.
Provider Organization Name (Legal Business Name) MEDGEN URGENT CARE VIRGINIA LLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address 6841 ELM ST
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Second Line Business Mailing Address #916
The second line mailing address of the provider being identified. This data element may contain the same information as ''Provider second line location address''.
Provider Business Mailing Address City Name MC LEAN
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name VA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 22101-0916
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 202-258-1627
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 844-213-1098
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 3117 DUKE ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name ALEXANDRIA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name VA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 22314-4518
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 703-751-8800
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 02/12/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 04/10/2019
The date that a record was last updated or changed.
Authorized Official Last Name WALTERS
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name CLELIA
The first name of the authorized official
Authorized Official Title or Position PART OWNER
The title or position of the authorized official
Authorized Official Telephone Number 202-258-1627
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1 261QU0200X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 Urgent Care Clinic/Center
Healthcare Provider Taxonomy #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.