Organization Active NPI

Medic 1

  • Family Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1164456398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102201074 Issued in VA
Legal business name
MEDIC 1
Practice address
20 105 Plantation Dr
Fredericksburg, VA 22406
Phone
(540) 368-2020
Fax
(540) 368-2030
NPI assigned
Jul 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Aimee Vanessa Hegadorn
Title
Practice Manager
Phone
(540) 371-1664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 0102201074 VA Primary

Addresses

Primary practice location

20 105 Plantation Dr
Fredericksburg, VA 22406

Mailing address

3429 Jefferson Davis Hwy
Fredericksburg, VA 22408
Phone (540) 371-1664

National Provider Directory

National Provider Directory
Tax ID family
Medic 12 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20 Plantation Dr
Ste 105
Fredericksburg, VA 22406
Phone (540) 368-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164456398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 JEFFERSON DAVIS HWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22408",
            "telephone_number": "540-371-1664",
            "fax_number": "540-371-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 105 PLANTATION DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22406",
            "telephone_number": "540-368-2020",
            "fax_number": "540-368-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIC 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEGADORN",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_middle_name": "VANESSA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "540-371-1664",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102201074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.