Individual provider Active NPI

Richard Stewart Robertson Hargrove

  • Internal Medicine Physician
  • Salem, VA
National Provider Identifier
1124587324
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102207324 Issued in VA
Practice address
1900 Electric Rd
Salem, VA 24153-7474
Phone
(540) 776-4000
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102207324 VA Primary

Addresses

Primary practice location

1900 Electric Rd
Salem, VA 24153-7474

Mailing address

16637 MLC LN
Rockville, VA 23146-1855
Phone (804) 514-2257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912003396 VA Practitioner - Osteopathic Manipulative Medicine 2567792807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Liberty Univ College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Spring Physician Services, LLCGroup PAC ID 1254689482, 89 clinicians
Oandw EnterprisesGroup PAC ID 6608927298, 216 clinicians

Practice addresses (Care Compare)

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

935 Fairystone Park Hwy
Stanleytown, VA 24168-3014
Phone (888) 724-0268

Hospital & facility affiliations

  • Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
  • Lewisgale Hospital Alleghany Hospital, Low Moor, VA, CCN 490126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102207324VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Spring Physician Services, LLC CurrentSince Jul 30, 2022 Accepting new patients

Locations

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: richard.hargrove@hca6.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1124587324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16637 MLC LN",
            "city": "ROCKVILLE",
            "state": "VA",
            "postal_code": "231461855",
            "telephone_number": "804-514-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "540-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "RICHARD",
        "middle_name": "STEWART ROBERTSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102207324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.