Middle Peninsula Medical Center Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MIDDLE PENINSULA MEDICAL CENTER INC

Practice address

9184 Buckley Hall Rd
Mathews, VA 23109-2309

Phone

(804) 725-0100

Fax

(804) 725-3158

NPI assigned

Nov 3, 2016

Organization subpart

No

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

Authorized official

Name

Thomas L. Wathen

Title

Vice President

Phone

(804) 384-7902

Specialties & licenses 1

Addresses

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 3

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

• Kimberly Odel Burnett, FNP

  • Family Nurse Practitioner
  • Mathews, VA
  • NPI 1720304967

  VA

  Medicare reassignment Care Compare group NPD
• Christian F. Wathen, M.D.

  • Internal Medicine Physician
  • Mathews, VA
  • NPI 1457384232

  Internal Medicine, VA

  Medicare reassignment Care Compare group NPD
• Leah Hurst, FNP-C

  • Family Nurse Practitioner
  • Mathews, VA
  • NPI 1912538182

  VA

  Medicare reassignment NPD

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1275085599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1498",
            "city": "MATHEWS",
            "state": "VA",
            "postal_code": "231091498",
            "telephone_number": "804-725-0100",
            "fax_number": "804-725-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9184 BUCKLEY HALL RD",
            "city": "MATHEWS",
            "state": "VA",
            "postal_code": "231092309",
            "telephone_number": "804-725-0100",
            "fax_number": "804-725-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE PENINSULA MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "WATHEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-384-7902"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyful Journeys Transportation LLC
• Keda,LLC
• Lynette R Glockner, Inc.
• Mathews County Public Schools
• Robert A May, R.PH
• Kathryn Charles Miles, PMHNP-BC
• Debra Giuliana Moore-Zierow, FNP-BC, PMHNP-BC
• Lisa Morse
• Ashley Murphy, LMFT
• Patrick Henry Hospital, Inc.

• All providers in Mathews, VA
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.