Charlottesville Plastic Surgery

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

CHARLOTTESVILLE PLASTIC SURGERY

Practice address

1410 Incarnation Dr Ste 205a
Charlottesville, VA 22901-5708

Phone

(434) 227-5333

Fax

(434) 483-5040

NPI assigned

Jan 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Rhett Nicholson Willis Jr., MDNPI 1861798696

Title

Owner

Phone

(434) 227-5333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 2

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

• Rhett N Willis Jr., M.D.

  • Plastic Surgery Physician
  • Charlottesville, VA
  • NPI 1861798696
  Medicare reassignment NPD Authorized official
• Jessica Biagiotti, MD

  • Student in an Organized Health Care Education/Training Program
  • Chapel Hill, NC
  • NPI 1508487810

  VA

  Medicare reassignment

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1083245161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DR STE 205A",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229015708",
            "telephone_number": "434-227-5333",
            "fax_number": "434-483-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DR STE 205A",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229015708",
            "telephone_number": "434-227-5333",
            "fax_number": "434-483-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTESVILLE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "RHETT",
        "authorized_official_middle_name": "NICHOLSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-227-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.