Organization Active NPI

Berryville Family Practice

  • Internal Medicine Physician
  • Winchester, VA
National Provider Identifier
1093990103
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101049881 Issued in VA
Legal business name
BERRYVILLE FAMILY PRACTICE
Practice address
1824 W Plaza Dr
Winchester, VA 22601-6365
Phone
(540) 723-6660
Fax
(540) 723-6688
NPI assigned
Jan 8, 2008
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Frances Russell Evans, MDNPI 1174622864
Title
Ceo
Phone
(540) 723-6660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101049881 VA Primary

Addresses

Primary practice location

1824 W Plaza Dr
Winchester, VA 22601-6365

Mailing address

1824 W Plaza Dr
Winchester, VA 22601-6365
Phone (540) 723-6660

Other identifiers 3

IdentifierTypeStateIssuer
3810013816MedicaidWV
CM4956OtherVAMEDICARE RR
1093990103MedicaidVA

National Provider Directory

National Provider Directory

Locations

1824 Plaza Dr
Winchester, VA 22601
Phone (540) 667-3005

1824 Plaza Dr
Ste D
Winchester, VA 22601
Phone (540) 723-6660

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1093990103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 W PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-723-6660",
            "fax_number": "540-723-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 W PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-723-6660",
            "fax_number": "540-723-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRYVILLE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "540-723-6660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101049881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810013816",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CM4956",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093990103",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.