NPIMap

Organization Active NPI

Tri-City Multi-Specialty, LLC

  • Family Medicine Physician
  • Hopewell, VA
National Provider Identifier
1134450448
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRI-CITY MULTI-SPECIALTY, LLC
Practice address
906 Crossings Blvd
Suite C
Hopewell, VA 23860-6503
Phone
(804) 415-5000
Fax
(804) 415-5015
NPI assigned
Jan 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President
Phone
(804) 237-7760

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

906 Crossings Blvd
Suite C
Hopewell, VA 23860-6503

Mailing address

906 Crossings Blvd
Suite C
Hopewell, VA 23860-6503
Phone (804) 415-5000

Other identifiers 1

IdentifierTypeStateIssuer
1134450448MedicaidVA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

281 E Hundred Rd
#140
Chester, VA 23836
Phone (804) 452-1635

906 Crossings Blvd
Ste C
Hopewell, VA 23860
Phone (804) 415-5000

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1134450448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 CROSSINGS BLVD",
            "address_2": "SUITE C",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238606503",
            "telephone_number": "804-415-5000",
            "fax_number": "804-415-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 CROSSINGS BLVD",
            "address_2": "SUITE C",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238606503",
            "telephone_number": "804-415-5000",
            "fax_number": "804-415-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY MULTI-SPECIALTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-237-7760"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134450448",
            "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.

Verify at the official NPI Registry.