Active NPI
Peter N Ault, MD
- Internal Medicine Physician
- Hopewell, VA
National Provider Identifier
1134192602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101029899
- Practice address
- 815 W Poythress St
Hopewell, VA 23860-2532 - Phone
- (804) 458-8557
- Fax
- (804) 541-7113
- NPI assigned
- Feb 7, 2006
- Last updated
- Sep 7, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101029899 | VA | Primary |
Addresses
Primary practice location
815 W Poythress St
Hopewell, VA 23860-2532
Mailing address
815 W Poythress St
Hopewell, VA 23860-2532
Phone (804) 458-8557
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134192602 | Medicaid | VA | |
| 226152 | Other | VA | ANTHEM |
| 005829062 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101029899 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-City Multi-Specialty, LLC | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Hopewell, VA
- NPI 1134450448
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1134192602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 W POYTHRESS ST",
"city": "HOPEWELL",
"state": "VA",
"postal_code": "238602532",
"telephone_number": "804-458-8557",
"fax_number": "804-541-7113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 W POYTHRESS ST",
"city": "HOPEWELL",
"state": "VA",
"postal_code": "238602532",
"telephone_number": "804-458-8557",
"fax_number": "804-541-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AULT",
"first_name": "PETER",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101029899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1134192602",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "226152",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005829062",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hopewell, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.