Trillium Medical Group of Virginia

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

TRILLIUM MEDICAL GROUP OF VIRGINIA

Practice address

Hwy 58
Dryden, VA 24243

Phone

(800) 750-8103

Fax

(866) 788-0863

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Bobby L Coates

Title

President

Phone

(727) 403-5221

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Trillium Medical Group of Virginia2 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.

• Trillium Medical Group of Virginia, Inc.

  • Rural Health Clinic/Center
  • Duffield, VA
  • NPI 1043421894
  NPD tax ID

Practitioners 2

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

• Deborah D Barton, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Greeneville, TN
  • NPI 1063462570
  NPD (past)
• Bahman Payman, MD

  • Obstetrics & Gynecology Physician
  • Bishop, CA
  • NPI 1871905778
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164623211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23788",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336233788",
            "telephone_number": "800-750-8103",
            "fax_number": "866-788-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 58",
            "city": "DRYDEN",
            "state": "VA",
            "postal_code": "24243",
            "telephone_number": "800-750-8103",
            "fax_number": "866-788-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MEDICAL GROUP OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COATES",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-403-5221"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "202887",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Health and Wellness Centers LLC
• Rodney Shane Moore
• Patient Assist, LLC
• Mary Pennington
• Strategic Healthcare of Virginia, Incorporated

• Rural Health Clinic/Center in Dryden, VA
• Providers in Dryden, VA by specialty
• Rural Health Clinic/Center in Virginia

• 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.