NPI 1790644516 · live from the CMS NPI Registry
Aevum Integrated Health Va LLC
General Practice in Farmville, VA. National Provider Identifier 1790644516, active.
NPI record
| NPI | 1790644516 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | General Practice 208D00000X |
| Practice location | 202 Agee St, Farmville, VA 23901 |
| Practice phone | 434-603-4835 |
| Mailing address | 175 Route 70 Ste 303, Toms River, NJ 08755 |
| Enumerated | January 19, 2026 |
| Last updated | January 28, 2026 |
| Authorized official | Levi Lipovenko, Ceo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | — |
| Nurse Practitioner, Family | 363LF0000X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
| General Practice primary | 208D00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.