Organization Active NPI

Siloam Direct Primary Care, PLLC

  • Family Medicine Physician
  • Waynesboro, VA
National Provider Identifier
1033909247
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SILOAM DIRECT PRIMARY CARE, PLLC
Practice address
15 Pratts Run Ste A01
Waynesboro, VA 22980-6606
Phone
(540) 221-2959
NPI assigned
May 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Katy Lopez Vasquez, MDNPI 1174833370
Title
Physician
Phone
(540) 221-2959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

15 Pratts Run Ste A01
Waynesboro, VA 22980-6606

Mailing address

15 Pratts Run Ste A01
Waynesboro, VA 22980-6606
Phone (540) 221-2959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250730003968 VA Part B Supplier - Clinic/Group Practice 7517474752 Receives reassigned benefits from 1 practitioner
Practice locations: Waynesboro, VA

National Provider Directory

National Provider Directory

Locations

15 Pratts Run
Ste A01
Waynesboro, VA 22980
Phone (540) 221-2959

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1033909247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PRATTS RUN STE A01",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229806606",
            "telephone_number": "540-221-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PRATTS RUN STE A01",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229806606",
            "telephone_number": "540-221-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILOAM DIRECT PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "LOPEZ VASQUEZ",
        "authorized_official_first_name": "KATY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "540-221-2959",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.