Virginia Center for Preventative Medicine, LL

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VIRGINIA CENTER FOR PREVENTATIVE MEDICINE, LL

Doing business as

Virginia Center for Preventative Medicine

Practice address

11551 Nuckols Rd Ste C
Glen Allen, VA 23059-5565

Phone

(804) 888-6800

Fax

(804) 888-6804

NPI assigned

Jun 19, 2020

Last updated

Jun 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William Stewart

Title

Ceo

Phone

(704) 995-1168

Specialties & licenses 1

Addresses

Other names 1

• Virginia Center for Preventative Medicine Doing business as

Locations

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1134745763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD STE C",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-888-6800",
            "fax_number": "804-888-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 NUCKOLS RD STE C",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595565",
            "telephone_number": "804-888-6800",
            "fax_number": "804-888-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA CENTER FOR PREVENTATIVE MEDICINE, LL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-995-1168",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Center for Preventative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.