MEDICARE: BODY JOURNEY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1164391355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY JOURNEY, LLC

Provider Business Mailing Address
First Line	:	9460 AMBERDALE DR STE D
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1259
Country	:	US
Telephone Number	:	804-728-2278
Fax Number	:	804-999-0450

Provider Business Practice Location Address
First Line	:	9460 AMBERDALE DR STE D
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1259
Country	:	US
Telephone Number	:	804-728-2278
Fax Number	:	804-999-0450

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MELODY E BOXLEY
Credential	:	FNP-C, PMHNP-BC
Telephone Number	:	434-222-5730

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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