NPIMap

Organization Active NPI

Mountain View Ear Nose and Throat

  • Otolaryngology Physician
  • Winchester, VA
National Provider Identifier
1154349975
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0101034967 Issued in VA
Legal business name
MOUNTAIN VIEW EAR NOSE AND THROAT
Practice address
112 Medical Cir
Winchester, VA 22601-3322
Phone
(540) 542-1995
Fax
(540) 542-1996
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Mrs. Kimberly Dawn Kerns
Title
Office Manager
Phone
(540) 542-1995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 0101034967 VA Primary

Addresses

Primary practice location

112 Medical Cir
Winchester, VA 22601-3322

Mailing address

112 Medical Cir
Winchester, VA 22601-3322
Phone (540) 542-1995

Other identifiers 3

IdentifierTypeStateIssuer
013390M89OtherMEDICARE ID
006503586MedicaidVA
1306873906MedicaidWV

National Provider Directory

National Provider Directory

Locations

112 Medical Cir
Winchester, VA 22601
Phone (540) 542-1995

Practitioners & affiliated clinicians

Practitioners 3

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": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1154349975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MEDICAL CIR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013322",
            "telephone_number": "540-542-1995",
            "fax_number": "540-542-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MEDICAL CIR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013322",
            "telephone_number": "540-542-1995",
            "fax_number": "540-542-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW EAR NOSE AND THROAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "KERNS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-542-1995",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101034967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "013390M89",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006503586",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306873906",
            "state": "WV"
        }
    ],
    "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 Mar 10, 2011; 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.