Samuel D Vernon, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101025422 Issued in VA

Practice address

1070 Terrace Dr
Marion, VA 24354-4138

Phone

(276) 781-2225

Fax

(276) 783-8843

NPI assigned

Jun 30, 2005

Last updated

Feb 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Royal Oak Medical Associates PC

  dba Smyth County Family Physicians

  • Family Medicine Physician
  • Marion, VA
  • NPI 1720035959
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1285631796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 TERRACE DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544138",
            "telephone_number": "276-781-2225",
            "fax_number": "276-783-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 TERRACE DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544138",
            "telephone_number": "276-781-2225",
            "fax_number": "276-783-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101025422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "202760",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285631796",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00197424",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "0385921",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "144631",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinity Ambulance Service, LLC
• Charlene M Truhlik, DC
• Natalie Elaine Tucker
• Cassandra Eden Untiedt, LPC
• Mary Abigail Henley Vencill, PHARMD
• Leisa Jane Vestal, LCSW
• Virginia CVS Pharmacy LLC (CVS Pharmacy # 07526)
• Thomas William Voglewede, OD
• Sophia Von Dauber
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1336)

• Internal Medicine Physician in Marion, VA
• Providers in Marion, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.