Family Doctor, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101038249 Issued in VA

Legal business name

FAMILY DOCTOR, PLLC

Practice address

511 Roanoke Blvd
Suite B
Salem, VA 24153-5006

Phone

(540) 389-0092

Fax

(540) 389-0644

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Kristin T Bell

Title

Office Manager

Phone

(540) 389-0092

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1285845305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 ROANOKE BLVD",
            "address_2": "SUITE B",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535006",
            "telephone_number": "540-389-0092",
            "fax_number": "540-389-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 ROANOKE BLVD",
            "address_2": "SUITE B",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535006",
            "telephone_number": "540-389-0092",
            "fax_number": "540-389-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DOCTOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2010-05-27",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "540-389-0092",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101038249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010173671",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Salem, VA
• Providers in Salem, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.