NPIMap

Organization Active NPI

Forest Family Care, Inc

  • Primary Care Clinic/Center
  • Wytheville, VA
National Provider Identifier
1316270804
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0101045977 Issued in VA
Legal business name
FOREST FAMILY CARE, INC
Practice address
1785 W Lee Hwy
Wytheville, VA 24382
Phone
(276) 228-3355
NPI assigned
Sep 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Authorized official

Name
Susan U MooreNPI 1770593212
Title
Owner
Phone
(276) 228-6499

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0101045977 VA Primary

Addresses

Primary practice location

1785 W Lee Hwy
Wytheville, VA 24382

Mailing address

PO Box 662
Wytheville, VA 24382-0662
Phone (276) 228-6499

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100312000859 VA Part B Supplier - Clinic/Group Practice 4284769415 Receives reassigned benefits from 11 practitioners
Practice locations: Rural Retreat, VA; Wytheville, 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
49D2004060Bhma Forest Family Care1785 West Lee Highway, Wytheville, VA 24382Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1316270804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243820662",
            "telephone_number": "276-228-6499",
            "fax_number": "276-228-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "24382",
            "telephone_number": "276-228-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-228-6499"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101045977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.