OrganizationActive
Nmg Affiliate Practice I, LLC
NPI 1427650340 · Internal Medicine Physician · Manassas, VA
Provider details
- NPI number
- 1427650340
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Nmg Affiliate Practice I, LLC
- Organization subpart
- Yes
- Authorized official
- Shala Davis, Enrollment Mnaager(704) 316-7845
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8644 Sudley Rd Ste 315
Manassas, VA 20110-4425
Phone: (703) 369-8405
Street-level locationGet directions
Mailing address
Po Box 60447
Charlotte, NC 28260-0447
Other names (DBA / former)
- Doing business as
- Novant Health Uva Health Systemdiabetes & Nutrition Manassas
Registry dates
- Enumerated
- 2020-11-16
- Last updated
- 2020-11-16
- Certified
- 2020-11-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.