William Richard Jeter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101027773 Issued in VA

Practice address

1800 Glenside Dr
Ste 110
Richmond, VA 23226-3769

Phone

(804) 288-1800

Fax

(804) 288-0515

NPI assigned

Jun 6, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Commonwealth Primary Care

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1750571287
  Medicare reassignment NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1295774131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "SUITE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-0399",
            "fax_number": "804-285-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "STE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-1800",
            "fax_number": "804-288-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101027773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005635497",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "141472",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080182274",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefanie Rasnick Jessee
• Jessica Bardenheier Counseling, LLC
• Douglas E Jessup, MD
• Alice N Jesudian, M.D.
• Michelle Jeter
• Jitendra Jethwani, DDS
• Ellen A Jett, LCSW
• Heather M. Jetton, O.D.
• Vybhav Jetty, MD, MHA
• Myrlene Jeudy, M.D.

• Family Medicine Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.