Family Healthcare of Wytheville, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102202346 Issued in VA

Legal business name

FAMILY HEALTHCARE OF WYTHEVILLE, PC

Practice address

1040 Holston Rd
Wytheville, VA 24382-4107

Phone

(276) 227-0200

Fax

(276) 227-0202

NPI assigned

May 13, 2009

Organization subpart

No

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

Authorized official

Name

Larissa Shae Parks

Title

Office Manager

Phone

(276) 227-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Practitioners 1

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

• John Michael Harkless, D.O.

  • Family Medicine Physician
  • Wytheville, VA
  • NPI 1083870455
  Medicare reassignment NPD

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1346474707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 HOLSTON RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824107",
            "telephone_number": "276-227-0200",
            "fax_number": "276-227-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HOLSTON RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824107",
            "telephone_number": "276-227-0200",
            "fax_number": "276-227-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE OF WYTHEVILLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_middle_name": "SHAE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "276-227-0200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346474707",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Tyler Epperson, RDN
• Jessica Dawn Evans, PT
• Kimeran Withrow Evans, PHYSICAL THERAPIST
• Everybody Connect Incorporated
• Dalkeith George Facey, D.O. MBA
• Family Preservation Services, Inc
• Jean Farley, BA
• Michelle Lavonne Farmer, LPC
• Elizabeth Victoria Felts, LPC
• Oscar Fernando Figueroa, M.D.

• Family Medicine Physician in Wytheville, VA
• Providers in Wytheville, 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 Mar 2, 2021; 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.