Ainsley Medical LLC

Organization Active NPI Emergency Care Clinic/Center · Danville, VA

NPI 1265124689 · NPPES record last updated Jul 5, 2023

Key facts

NPI
1265124689
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Care Clinic/Center 261QE0002X
Legal business name
AINSLEY MEDICAL LLC
Practice address
1108 Main St
Danville, VA 24541-2940
Phone
(434) 421-6180
Fax
(434) 421-4974
NPI assigned
May 24, 2023
Organization subpart
No

Authorized official

Name
Dr. Mark Ainsley Innis, MD
Title
Physician
Phone
(434) 421-6180

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230920001427 VA Part B Supplier - Clinic/Group Practice 6204280597 Receives reassigned benefits from 4 practitioners
Practice locations: Danville, VA

National Provider Directory

Tax ID family
Ainsley Medical (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QA0505X
Emergency Care Clinic/Center 261QE0002X Yes

Addresses

Primary practice location

1108 Main St
Danville, VA 24541-2940

Mailing address

1108 Main St
Danville, VA 24541-2940
Phone (434) 421-6180

Other names

  • Ainsley Medical LLC Former legal business name

Other providers in Danville, VA

All providers in Danville, VA · Emergency Care Clinic/Center in Virginia

Sources for this page

Verify at the official NPI Registry.