Provider Demographics
NPI:1538431523
Name:MVP ASSISTING, LLC
Entity type:Organization
Organization Name:MVP ASSISTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:703-395-3885
Mailing Address - Street 1:35731 DUNTHORPE LN
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-5225
Mailing Address - Country:US
Mailing Address - Phone:703-395-3885
Mailing Address - Fax:
Practice Address - Street 1:35731 DUNTHORPE LN
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-5225
Practice Address - Country:US
Practice Address - Phone:540-668-6350
Practice Address - Fax:540-668-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001565363AS0400X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS373126-4OtherCOMMONWEALTH OF VIRGINIA