NPIMap

Organization Active NPI

Russell County Clinic Corp

Doing business as Lebanon Pediatrics

  • Pediatrics Physician
  • Lebanon, VA
National Provider Identifier
1003834441
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
RUSSELL COUNTY CLINIC CORP
Doing business as
Lebanon Pediatrics
Practice address
640 Overlook Drive
Lebanon, VA 24266
Phone
(276) 889-0201
Fax
(276) 889-0018
NPI assigned
Jul 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Miller
Title
Group VP
Phone
(286) 889-0201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

640 Overlook Drive
Lebanon, VA 24266

Mailing address

PO Box 3600
Lebanon, VA 24266-0200
Phone (276) 889-0201

Other names 1

  • Lebanon Pediatrics Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003834441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3600",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242660200",
            "telephone_number": "276-889-0201",
            "fax_number": "276-889-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 OVERLOOK DRIVE",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "24266",
            "telephone_number": "276-889-0201",
            "fax_number": "276-889-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL COUNTY CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "GROUP VP",
        "authorized_official_telephone_number": "286-889-0201"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.