Nansemond Family Practice, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101045475 Issued in VA

Legal business name

NANSEMOND FAMILY PRACTICE, LLC

Practice address

206 Gumwood Dr
Suite a
Smithfield, VA 23430-6087

Phone

(757) 365-9090

Fax

(757) 365-9095

NPI assigned

Oct 24, 2006

Last updated

Jan 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald Elwood Soles Jr., M.D.NPI 1154312247

Title

Member

Phone

(757) 365-9090

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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.

• Donald E Soles Jr., MD

  • Family Medicine Physician
  • Smithfield, VA
  • NPI 1154312247
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1245313857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 GUMWOOD DR",
            "address_2": "SUITE A",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234306087",
            "telephone_number": "757-365-9090",
            "fax_number": "757-365-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GUMWOOD DR",
            "address_2": "SUITE A",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234306087",
            "telephone_number": "757-365-9090",
            "fax_number": "757-365-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANSEMOND FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "SOLES",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ELWOOD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "757-365-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101045475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "431477",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005600367",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH/SENTARA",
            "identifier": "24513",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Smithfield, VA
• Providers in Smithfield, 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 Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.