Ivy Family Medicine, PLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101057199 Issued in VA

Legal business name

IVY FAMILY MEDICINE, PLC

Practice address

2 Boars Head PL
Suite 110
Charlottesville, VA 22903-4611

Phone

(434) 466-8363

NPI assigned

Jan 12, 2011

Last updated

Apr 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lily Wise Hargrove, MDNPI 1740249317

Title

Owner

Phone

(434) 466-8363

Specialties & licenses 1

Addresses

Locations

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.

• Lily Wise Hargrove, M.D.

  • Family Medicine Physician
  • Charlottesville, VA
  • NPI 1740249317
  Authorized official Same address or phone

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303084800000",
    "number": "1073818787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 ROOKWOOD PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229034734",
            "telephone_number": "434-466-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BOARS HEAD PL",
            "address_2": "SUITE 110",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229034611",
            "telephone_number": "434-466-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY FAMILY MEDICINE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-04-18",
        "status": "A",
        "authorized_official_last_name": "HARGROVE",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "WISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-466-8363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101057199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klaus Ito, OD
• Ina S Itzkovitz, MD
• Lauren Elizabeth Ivey, MD
• Ivy Commons Family Chiropractic
• Ivy Counseling and Wellness LLC
• Ivy Road Family Solutions
• Ivyrehab Sept, LLC (Spectrum Physical Therapy)
• Ivyrehab Sept, LLC
• Josephine Emma Iwatsubo
• Siddhanth Iyer, MD

• Primary Care Clinic/Center in Charlottesville, VA
• Providers in Charlottesville, 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 Apr 18, 2011; 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.