LIGHTHOUSE FAMILY MEDICINE AND WELLNESS PLLC
NPI 1164003752
Family Medicine in Lansdowne, VA

Q: What is Lighthouse Family Medicine And Wellness PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 15, 2021CLIA 49D2234273 · Waiver

19440 GOLF VISTA PLZ STE 120, LANSDOWNE, VA 20176(571) 293-2424(833) 913-2348 Get Directions Write a Review

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 30, 2021, Aug 24, 2021, Apr 15, 2021 (3 updates tracked since 2021).

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About Lighthouse Family Medicine And Wellness Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHTHOUSE FAMILY MEDICINE AND WELLNESS PLLC (NPI 1164003752) is a healthcare organization registered as a family medicine in Lansdowne, Virginia and active in the NPI registry since April 2021. The organization holds a CLIA Waiver certificate valid through August 29, 2027 and lists Olufunmilola Modupe Ogbonlowo, Physician, as its authorized official.

NPPES Registry Identity

NPI1164003752

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameLIGHTHOUSE FAMILY MEDICINE AND WELLNESS PLLC

Location Address19440 GOLF VISTA PLZ STE 120Lansdowne, VA 20176-8264

Mailing Address19440 Golf Vista Plz Ste 120Lansdowne, VA 20176-8264 · (571) 293-2424 · Fax (833) 913-2348

Phone(571) 293-2424

Fax(833) 913-2348

Organization SubpartNo

Authorized OfficialOlufunmilola Modupe OgbonlowoPhysician · (571) 293-2424

Enumeration DateApril 15, 2021

Last NPPES UpdateOctober 31, 20253 updates tracked since enumeration

NPPES CertifiedOctober 31, 2025

✔ NPI 1164003752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

19440 GOLF VISTA PLZ STE 120, Lansdowne, VA 20176

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2234273

Lighthouse Family Medicine And Wellness PLLC · Lansdowne, VA

Active · expires Aug 29, 2027

CLIA Number49D2234273

Laboratory TypePhysician Office

Certificate Effective DateAugust 30, 2025

Certificate Expiration DateAugust 29, 2027

Laboratory DirectorOlufunmilola M. Ogbonlowo

Laboratory Phone(571) 293-2424

Laboratory LocationLighthouse Family Medicine And Wellness PLLC19440 Golf Vista Plaza, Suite 120, Lansdowne, VA 20176

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. OLUFUNMILOLA MODUPE OGBONLOWO M.D.

Family Medicine

19440 GOLF VISTA PLZ STE 120
LANSDOWNE, VA 20176

Loudoun County (571) 293-2424

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lighthouse Family Medicine And Wellness PLLC's NPI number?

The NPI number for Lighthouse Family Medicine And Wellness PLLC is 1164003752. It was assigned to this organization in the NPPES registry on April 15, 2021.

Where is Lighthouse Family Medicine And Wellness PLLC located?

Lighthouse Family Medicine And Wellness PLLC is located at 19440 Golf Vista Plz Ste 120, Lansdowne, VA 20176. The listed phone number is (571) 293-2424.

What is Lighthouse Family Medicine And Wellness PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Lighthouse Family Medicine And Wellness PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2234273) is associated with this NPI, valid through August 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lighthouse Family Medicine And Wellness PLLC was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.