Organization Active NPI

Plastic Surgery Center of Virginia

  • Plastic Surgery Physician
  • Blacksburg, VA
National Provider Identifier
1073562047
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
0101051261 Issued in VA
Legal business name
PLASTIC SURGERY CENTER OF VIRGINIA
Practice address
817 Davis St
Suite 2
Blacksburg, VA 24060-7013
Phone
(540) 951-8885
Fax
(540) 951-8887
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Dr. Philip E. Grubbs, MD
Title
President
Phone
(540) 951-3429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 0101051261 VA Primary

Addresses

Primary practice location

817 Davis St
Suite 2
Blacksburg, VA 24060-7013

Mailing address

817 Davis St
Suite 2
Blacksburg, VA 24060-7013
Phone (540) 951-8885

Other identifiers 1

IdentifierTypeStateIssuer
006900241MedicaidVA

National Provider Directory

National Provider Directory

Locations

817 Davis St
Ste B
Blacksburg, VA 24060

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1073562047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 DAVIS ST",
            "address_2": "SUITE 2",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607013",
            "telephone_number": "540-951-8885",
            "fax_number": "540-951-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 DAVIS ST",
            "address_2": "SUITE 2",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607013",
            "telephone_number": "540-951-8885",
            "fax_number": "540-951-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CENTER OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "GRUBBS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-951-3429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101051261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006900241",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.