| Beckwith Integrative Medicine, Pllc | |
|
952 Edwards Ferry Rd Ne Leesburg VA 20176-3324 | |
| (703) 687-4158 | |
| (703) 687-4159 |
| Full Name | Beckwith Integrative Medicine, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 952 Edwards Ferry Rd Ne, Leesburg, Virginia |
| Authorized Official Name and Position | Roshelle Beckwith (OWNER) |
| Authorized Official Contact | 7036874158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beckwith Integrative Medicine, Pllc 952 Edwards Ferry Rd Ne Leesburg VA 20176-3324 Ph: (703) 687-4158 | Beckwith Integrative Medicine, Pllc 952 Edwards Ferry Rd Ne Leesburg VA 20176-3324 Ph: (703) 687-4158 |
| NPI Number | 1891347266 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 07/15/2019 |
| Medicare PECOS PAC ID | 0941633168 |
|---|---|
| Medicare Enrollment ID | O20191202001974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891347266 | NPI | - | NPPES |
| 1235162280 | Medicaid | VA | |
| 1326514316 | Other | VA | 1326514316 |
| 1235162280 | Other | VA | 1235162280 |
| 1326514316 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Roshelle Jenifer Beckwith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043358971 PECOS PAC ID: 8729153044 Enrollment ID: I20130815000898 |
| Provider Name | Matthew G Beckwith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235162280 PECOS PAC ID: 4183754146 Enrollment ID: I20130815000915 |
| Provider Name | Lucille Tussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326514316 PECOS PAC ID: 5991138117 Enrollment ID: I20191202002160 |
| Provider Name | Rosy Pradhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205477791 PECOS PAC ID: 7416353339 Enrollment ID: I20210901002346 |
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