Organization Active NPI

Faith Medical & Wellness Clinic, LLC

  • Family Medicine Physician
  • Woodlawn, VA
National Provider Identifier
1235845033
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAITH MEDICAL & WELLNESS CLINIC, LLC
Practice address
22 Training Center Rd
Woodlawn, VA 24381-3518
Phone
(276) 266-3134
Fax
(276) 266-3086
NPI assigned
Jan 25, 2023
Last updated
Apr 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Kimberly Nichole Horton, FNP-BCNPI 1114464963
Title
FNP-BC / Owner
Phone
(276) 266-3134

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

22 Training Center Rd
Woodlawn, VA 24381-3518

Mailing address

PO Box 811
Hillsville, VA 24343-0811
Phone (276) 266-3134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504000687 VA Part B Supplier - Clinic/Group Practice 2769847359 Receives reassigned benefits from 1 practitioner
Practice locations: Hillsville, VA

National Provider Directory

National Provider Directory

Locations

1141 W Stuart Dr
Hillsville, VA 24343
Phone (276) 266-3134

Practitioners & affiliated clinicians

Practitioners 1

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": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1235845033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 811",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243430811",
            "telephone_number": "276-266-3134",
            "fax_number": "276-266-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TRAINING CENTER RD",
            "city": "WOODLAWN",
            "state": "VA",
            "postal_code": "243813518",
            "telephone_number": "276-266-3134",
            "fax_number": "276-266-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH MEDICAL & WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "FNP-BC / OWNER",
        "authorized_official_telephone_number": "276-266-3134",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlawn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.