Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Livewell Passport of VA LLC

Organization Family Medicine Physician · NPI 1366136418

Livewell Passport of VA LLC is a Family Medicine Physician in Midlothian, Virginia. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

13553 Midlothian Tpke
Midlothian, VA 23113-4261
Phone: (804) 229-1554
Fax: (844) 777-1754
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1366136418
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremiah Fabry — Manager · (804) 229-1554
NPI enumeratedJune 2, 2023
Last updated in NPPESJune 2, 2023
Certification dateJune 2, 2023
Mailing address15801 Swindon Way, Midlothian, VA 23112-5531

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