Kempsville Primary Medical Care Center Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101034998 Issued in VA

Legal business name

KEMPSVILLE PRIMARY MEDICAL CARE CENTER INC

Practice address

5136 Princess Anne Rd
Virginia BCH, VA 23462-4228

Phone

(757) 473-0003

Fax

(757) 497-9510

NPI assigned

Mar 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Josue Apilan Miranda, MDNPI 1821038555

Title

Owner

Phone

(757) 473-0003

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Josue A Miranda, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1821038555
  NPD Authorized official

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1013187947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 PRINCESS ANNE RD",
            "city": "VIRGINIA BCH",
            "state": "VA",
            "postal_code": "234624228",
            "telephone_number": "757-473-0003",
            "fax_number": "757-497-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 PRINCESS ANNE RD",
            "city": "VIRGINIA BCH",
            "state": "VA",
            "postal_code": "234624228",
            "telephone_number": "757-473-0003",
            "fax_number": "757-497-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEMPSVILLE PRIMARY MEDICAL CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "JOSUE",
        "authorized_official_middle_name": "APILAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-473-0003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101034998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7320256",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Virginia BCH, VA
• Providers in Virginia BCH, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.