Organization Active NPI

Alliance Family Practice, P.C.

  • Family Medicine Physician
  • Petersburg, VA
National Provider Identifier
1174714141
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALLIANCE FAMILY PRACTICE, P.C.
Practice address
40 Liberty St
Petersburg, VA 23803-5021
Phone
(804) 862-2878
Fax
(804) 862-2879
NPI assigned
Aug 6, 2007
Last updated
Jun 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Dr. Zelda West Johnson, M.D.NPI 1801933007
Title
Family Practice Provider
Phone
(804) 862-2878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

40 Liberty St
Petersburg, VA 23803-5021

Mailing address

40 Liberty St
Petersburg, VA 23803-5021
Phone (804) 862-2878

Other identifiers 1

IdentifierTypeStateIssuer
302200OtherVAANTHEM BC OF VIRGINIA

National Provider Directory

National Provider Directory

Locations

9323 Midlothian Tpke
Ste E
North Chesterfield, VA 23235
Phone (804) 212-1144

3333 S Crater Rd
Ste 3A
Petersburg, VA 23805
Phone (804) 733-3438

40 Liberty St
Petersburg, VA 23803
Phone (804) 520-6868

Practitioners & affiliated clinicians

Practitioners 4

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": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1174714141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LIBERTY ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035021",
            "telephone_number": "804-862-2878",
            "fax_number": "804-862-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LIBERTY ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035021",
            "telephone_number": "804-862-2878",
            "fax_number": "804-862-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ZELDA",
        "authorized_official_middle_name": "WEST",
        "authorized_official_title_or_position": "FAMILY PRACTICE PROVIDER",
        "authorized_official_telephone_number": "804-862-2878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC OF VIRGINIA",
            "identifier": "302200",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.