Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Livewell Passport of VA LLC

Organization Family Medicine Physician · NPI 1366136418

Livewell Passport of VA LLC provides Family Medicine Physician services 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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