Chatham Family Medical Center, Inc
Organization Active NPI Family Medicine Physician · Chatham, VA
NPI 1225237456 · NPPES record last updated Nov 22, 2022
Key facts
- NPI
- 1225237456
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHATHAM FAMILY MEDICAL CENTER, INC
- Practice address
- 13908 US Highway 29
Chatham, VA 24531-3669 - Phone
- (434) 432-0216
- Fax
- (434) 432-3425
- NPI assigned
- Jul 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Minesh R Shah, M.D.
- Title
- President/Physician
- Phone
- (434) 432-0216
Practitioners 3
-
Minesh Shah, M.D.
-
Waclaw Wedzina, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D1072039 | Chatham Family Medical Center, Inc | Certificate of waiver | Aug 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071010000717 | VA | Part B Supplier - Clinic/Group Practice | 5890881593 |
Receives reassigned benefits from 1 practitioner Practice locations: Chatham, VA |
National Provider Directory
Locations
100 Rorer St
Chatham, VA 24531
Phone (434) 253-0877
13908 US Highway 29
Chatham, VA 24531
Phone (434) 432-0216
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AIDIBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
13908 US Highway 29
Chatham, VA 24531-3669
Mailing address
13908 US Highway 29
Chatham, VA 24531-3669
Phone (434) 432-0216
Other providers in Chatham, VA
- Angela Beth Bowman
- Joelle Shelton Bray
- Emily Hope Brown
- Jamerson Bryant
- Garrett Scott Bullock
- Chatham Family Pharmacy
- Chatham Health and Rehabilitation Center, LLC
- Chatham Rescue Squad Inc
- Nakindra Coates
- Commonwealth of VA State Board of Health
All providers in Chatham, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.