Organization Active NPI

Pleasant Valley Medical Center, Inc

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1295826071
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLEASANT VALLEY MEDICAL CENTER, INC
Practice address
4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519
Phone
(757) 495-7420
Fax
(757) 495-3917
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Abdur R Khan, M.D.NPI 1992766851
Title
President
Phone
(757) 495-7420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X VA Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X VA

Addresses

Primary practice location

4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519

Mailing address

4221 Pleasant Valley Rd
Suite 114
Virginia Beach, VA 23464-8519
Phone (757) 495-7420

Other identifiers 2

IdentifierTypeStateIssuer
330829OtherVABCBS
330828OtherVABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111109000589 VA Part B Supplier - Clinic/Group Practice 4688847536 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia Beach, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0859564Pleasant Valley Medical Center4221 Pleasant Valley Rd #114, Virginia Beach, VA 23464Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

4221 Pleasant Valley Rd
Virginia Beach, VA 23464
Phone (757) 685-4079

4221 Pleasant Valley Rd
Ste 114
Virginia Beach, VA 23464
Phone (757) 495-7420

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1295826071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 PLEASANT VALLEY RD",
            "address_2": "SUITE 114",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648519",
            "telephone_number": "757-495-7420",
            "fax_number": "757-495-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 PLEASANT VALLEY RD",
            "address_2": "SUITE 114",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234648519",
            "telephone_number": "757-495-7420",
            "fax_number": "757-495-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABDUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-495-7420",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "330829",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "330828",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.