Williamsburg Family Practice Clinic, Inc.

Key facts

NPI

1295738524

Entity type

Organization (NPI type 2)

Primary specialty

Nurse Practitioner 363L00000X

License

4464P (KY)

Legal business name

WILLIAMSBURG FAMILY PRACTICE CLINIC, INC.

Practice address

965 S Highway 25 W
Ste 52
Williamsburg, KY 40769-1608

Phone

(606) 549-2588

Fax

(606) 549-1945

NPI assigned

May 31, 2005

Organization subpart

No

Authorized official

Name

Robert A. Carter Jr.

Title

President

Phone

(606) 528-0283

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Williamsburg Family Practice Clinic Family Medicine Physician · Williamsburg, KY · NPI 1720030620
  NPD tax ID

National Provider Directory

Tax ID family

Williamsburg Family Practice (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295738524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1125",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407021125",
            "telephone_number": "606-528-0283",
            "fax_number": "606-528-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 S HIGHWAY 25 W",
            "address_2": "STE 52",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691608",
            "telephone_number": "606-549-2588",
            "fax_number": "606-549-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG FAMILY PRACTICE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-528-0283",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4464P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35001098",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

• Whitley Pharmacy, Inc.
• David Bernard Williams, MD
• Williamsburg Chiropractic Corp
• Williamsburg Family Medicine Center
• Williamsburg Family Practice Clinic
• Williamsburg Independent School District
• Williamsburg Nursing Home, Inc.
• Williamsburg Pharmacy
• Williamsburg Pharmacy Inc
• Kelli Leigh Williamson, M.S., CF-SLP

All providers in Williamsburg, KY · Nurse Practitioner in Kentucky