NPIMap

Organization Active NPI

Commonwealth Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Grundy, VA
National Provider Identifier
1235454646
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101246820 Issued in VA
Legal business name
COMMONWEALTH INTERNAL MEDICINE AND PEDIATRICS
Practice address
1532 Slate Creek Rd Ste 106
Box 173
Grundy, VA 24614-6975
Phone
(276) 935-1592
NPI assigned
Mar 30, 2010
Last updated
Mar 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Dr. Melissa Keene, MDNPI 1295943876
Title
Owner
Phone
(859) 907-4299

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101246820 VA Primary
Pediatrics Physician 208000000X 0101246820 VA

Addresses

Primary practice location

1532 Slate Creek Rd Ste 106
Box 173
Grundy, VA 24614-6975

Mailing address

PO Box 713
1532 Slate Creek Road Suite 106
Grundy, VA 24614-0713
Phone (276) 935-1592

National Provider Directory

National Provider Directory

Locations

1532 Slate Creek Rd
Ste 106
Grundy, VA 24614
Phone (276) 935-1592

Practitioners & affiliated clinicians

Practitioners 6

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": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1235454646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713",
            "address_2": "1532 SLATE CREEK ROAD SUITE 106",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246140713",
            "telephone_number": "276-935-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 SLATE CREEK RD STE 106",
            "address_2": "BOX 173",
            "city": "GRUNDY",
            "state": "VA",
            "postal_code": "246146975",
            "telephone_number": "276-935-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH INTERNAL MEDICINE AND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "KEENE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-907-4299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101246820",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101246820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grundy, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.