Isle of Wight Family Practice, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1023097615 Issued in VA

Legal business name

ISLE OF WIGHT FAMILY PRACTICE, LLC

Practice address

1807 South Church Street
Suite 200 C
Smithfield, VA 23430

Phone

(757) 332-6342

Fax

(757) 357-9214

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Cecelia Clarke, FNP

Title

Family Nurse Pratitioner

Phone

(757) 332-6342

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1275705196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SOUTH CHURCH STREET",
            "address_2": "SUITE 200 C",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "23430",
            "telephone_number": "757-332-6342",
            "fax_number": "757-357-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 SOUTH CHURCH STREET",
            "address_2": "SUITE 200 C",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "23430",
            "telephone_number": "757-332-6342",
            "fax_number": "757-357-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLE OF WIGHT FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "CECELIA",
        "authorized_official_title_or_position": "FAMILY NURSE PRATITIONER",
        "authorized_official_telephone_number": "757-332-6342",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "1023097615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Smithfield, VA
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.