Augusta Medical Group
Organization Active NPI Rural Health Clinic/Center · Glasgow, VA
NPI 1295318525 · NPPES record last updated May 4, 2021
Key facts
- NPI
- 1295318525
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- AUGUSTA MEDICAL GROUP
- Practice address
- 730 McCulloch St
Glasgow, VA 24555-2710 - Phone
- (540) 258-1700
- NPI assigned
- May 4, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- AUGUSTA HEALTH CARE, INC.
Authorized official
- Name
- Joseph Just
- Title
- President
- Phone
- (540) 258-1700
Owners & managing parties with NPI records 12
-
Jason M. Lawrence, M.D.
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 1
Facilities with the same owner 1
Practitioners 409
-
Nashwa Abdalla, FNP-C
-
Preeti Agarwala, M.D.
-
Rizwan Ahmed, M.D.
-
Claire K Akin, MD
-
Mark Andres, M.D.
-
Christy Ann Andrews, NURSE PRACTITIONER
-
Mustafa Anssar, MD
-
Ahmad Arab, M.D.
-
Gary L Aragon, M.D.
-
Owusu Asamoah, MD
-
Nabeel I. Babar, M.D.
-
Michon Bechamps, MD
-
Susan Neely Becker, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Rural health clinic certification: CCN 498934
- Legal name
- AUGUSTA MEDICAL GROUP
- Doing business as
- AUGUSTA HEALTH MAURY RIVER FAMILY PRACTICE
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 15, 2021
- Last certification
- Dec 15, 2021
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 18, 2008 in VA
- Enrollment address
- 730 McCulloch St
Glasgow, VA 24555-2710
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Augusta Health Care Inc |
5% Or Greater Direct Ownership Interest | Mar 18, 2008 | 100% |
| Scott Crabtree |
Corporate Officer | Aug 16, 2010 | |
| W-2 Managing Employee | Aug 16, 2010 | ||
| John E Mack |
Corporate Officer |
Sep 1, 2018 | |
| William J Meador |
Corporate Officer | May 22, 2023 | |
| W-2 Managing Employee | May 22, 2023 | ||
| Crystal Farmer |
Corporate Officer | Aug 6, 2018 | |
| W-2 Managing Employee | Aug 6, 2018 | ||
| Susan Knick |
W-2 Managing Employee |
Apr 16, 2020 | |
| Mary Mannix |
Corporate Officer |
Jan 1, 2008 | |
| W-2 Managing Employee |
Jan 1, 2008 | ||
| Richard Evans |
Corporate Director |
Apr 1, 2012 | |
| Shelley L Snodgrass |
Corporate Director |
Sep 25, 2006 | |
| W-2 Managing Employee |
Sep 25, 2006 | ||
| Kari O Lightner |
W-2 Managing Employee |
Feb 15, 2021 | |
| Jason M Lawrence |
Corporate Director |
Mar 19, 2020 | |
| Albert Morriss |
Corporate Director |
Apr 1, 2013 | |
| Kerry a Alexander |
Corporate Director |
Oct 1, 2016 | |
| Jacqueline Sims |
Corporate Director |
Mar 10, 1991 | |
| W-2 Managing Employee |
Mar 10, 1991 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210518000073 | VA | Part a Provider - Rural Health Clinic | 3678632544 | Practice locations: Glasgow, VA |
National Provider Directory
- Tax ID family
- Ah Maury River Family Practice
- Part of
- Augusta Medical Center
Locations
22 N Medical Park Dr
Fishersville, VA 22939
Phone (540) 213-2630
851 Statler Blvd
Staunton, VA 24401
Phone (540) 245-7470
201 Lew Dewitt Blvd
#B
Waynesboro, VA 22980
Phone (540) 245-7950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
730 McCulloch St
Glasgow, VA 24555-2710
Mailing address
730 McCulloch St
Glasgow, VA 24555-2710
Phone (540) 258-1700
Other names
- Augusta Health Maury River Family Practice
Other providers in Glasgow, VA
- Carolyn Elaine Beverly
- Building Bridges Group Home, LLC
- Beverly Caldwell
- Rebekah Leah Draper
- Kathryn Rose Eagle
All providers in Glasgow, VA · Rural Health Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.