New River Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NEW RIVER MEDICAL GROUP, LLC

Practice address

101 1St St NW
Pulaski, VA 24301-1641

Phone

(540) 980-0550

Fax

(540) 980-5010

NPI assigned

Dec 18, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyn P. Gardner

Title

Insurance Clerk

Phone

(540) 980-0550

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1235468323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1641",
            "address_2": "101 1ST ST. NW",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243011641",
            "telephone_number": "540-980-0550",
            "fax_number": "540-980-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 1ST ST NW",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243011641",
            "telephone_number": "540-980-0550",
            "fax_number": "540-980-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "INSURANCE CLERK",
        "authorized_official_telephone_number": "540-980-0550",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pulaski, VA
• Providers in Pulaski, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.