Village Internal Medicine, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

62468 Issued in NC

Legal business name

VILLAGE INTERNAL MEDICINE, PA

Practice address

1843 Quiet CV
Fayetteville, NC 28304-3857

Phone

(910) 483-8080

Fax

(910) 483-3258

NPI assigned

Jun 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Stuart Logue, MD

Title

President

Phone

(910) 483-8080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 7

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

• Fadi Deeb

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1962083832

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Toni D Meeks, MD

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1780617514
  Medicare reassignment Care Compare group NPD
• Sathyamurthy Viswanath, MD

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1861467581
  Medicare reassignment Care Compare group NPD
• Wikrom Chaiwatcharayut, M.D.

  • Internal Medicine Physician
  • Ventura, CA
  • NPI 1306259809

  NC

  Medicare reassignment Care Compare group NPD
• Daniela Marques

  • Physician Assistant
  • Philadelphia, PA
  • NPI 1265095657

  NC

  Medicare reassignment Care Compare group
• Elizabeth Tow

  • Family Nurse Practitioner
  • Sanford, NC
  • NPI 1760236970
  Medicare reassignment NPD
• Teshome Assefa Hailemichael, M.D.

  • Internal Medicine Physician
  • Easton, PA
  • NPI 1235373994
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1326074592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-483-8080",
            "fax_number": "910-483-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 QUIET CV",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043857",
            "telephone_number": "910-483-8080",
            "fax_number": "910-483-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE INTERNAL MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "LOGUE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-483-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "62468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890296P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William W Vick, M.D.
• Victorious Unwed Mothers' Home Inc.
• Village Family Care Center PA
• Village Green Health and Rehabilitation, LLC (Village Green Health and Rehabilitation)
• Village Home Care and Personnel Pool
• Village Pharmacy LLC (Village Pharmacy)
• Village Surgical Associates PA
• Latonya R. Villanueva, PHARMD
• Maria Joanna Villena, M.D.
• Deja Vinson

• Internal Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.