DLP Twin County Physician Practices LLC
Organization Active NPI Internal Medicine Physician · Independence, VA
NPI 1053687285 · NPPES record last updated Oct 10, 2024
Key facts
- NPI
- 1053687285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- DLP TWIN COUNTY PHYSICIAN PRACTICES LLC
- Practice address
- 217 S Independence Ave
Independence, VA 24348-2802 - Phone
- (276) 236-0065
- NPI assigned
- Apr 2, 2012
- Organization subpart
- No
Authorized official
- Name
- Charlotte Lawrence
- Title
- Secretary
- Phone
- (615) 920-7000
Other NPIs on the same Medicare enrollment 20
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 15
Practitioners 125
-
Emory Dante Gray, MD
-
John William Wittenborn, M.D.
-
Joy K Creed, FNP-C
-
Ali Dehart, MSN, APRN, AGACNP-BC
-
Travis Howell Edelstein, D.O.
-
Janet Hart Garvey, FNP-C
-
Shruthi Janardhanan, M.D.
-
Dalana Dawn Lane, NP
-
James M Lee, MD
-
Patricia Goad Osborne, FNP-BC
-
Rushi M Patel, MD
-
Linda Marie Radford-Goad, CFNP
-
Teresa Ray, AGACNP
-
Sherry Elaine Taylor, FNP
-
Tracie Vaughan, N.P.
-
Jaime Warren, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA, NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120503000011 | VA | Part B Supplier - Clinic/Group Practice | 7214199512 |
Receives reassigned benefits from 86 practitioners 20 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wytheville, VA; Winchester, VA; Sparta, NC; Independence, VA; Hillsville, VA; Goode, VA; Galax, VA; Charlottesville, VA… |
| O20140725001883 | NC | Part B Supplier - Clinic/Group Practice | 7214199512 |
Receives reassigned benefits from 4 practitioners 1 other NPI on this enrollment Practice locations: Wilson, NC; Winston Salem, NC; Sparta, NC; Cary, NC |
National Provider Directory
- Tax ID family
- DLP Twin County Physician Practices LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
217 S Independence Ave
Independence, VA 24348-2802
Mailing address
217 S Independence Ave
Independence, VA 24348-2802
Phone (276) 236-0065
Other names
- Independence Family Care Center
Other providers in Independence, VA
- Commonwealth of Virginia State Board of Health
- Booby Neal Cox
- Mary Elizabeth Dalton
- Nicholas James Derenzis
- Julianna Marie Digiacomo
- DLP Twin County Physician Practices LLC
- Karl Alan Fauble
- Lisa Funk
- Thomas M Gerni
- Grayson County Public Schools
All providers in Independence, VA · Internal Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.