Virginia McConville, PA C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

000630 Issued in IA

Practice address

19876 Saint Joseph Dr
Centerville, IA 52544-8850

Phone

(641) 856-8684

Fax

(641) 856-3009

NPI assigned

Oct 17, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mercy Medical Center-Centerville

  • Emergency Care Clinic/Center
  • Centerville, IA
  • NPI 1528018801
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1366431991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19876 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525448850",
            "telephone_number": "641-856-8684",
            "fax_number": "641-856-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19876 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525448850",
            "telephone_number": "641-856-8684",
            "fax_number": "641-856-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONVILLE",
        "first_name": "VIRGINIA",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "000630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00050538",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Lawrence
• Jeffery C Liston, LMSW
• Judith E Lunkley, L.C.S.W.
• Maple Grove Senior Living
• James Brad McConville, MD
• Olivia Catherine McCoy, ARNP
• Nicholas Michael McCullen, O.D.
• Linda C McDanolds, ARNP
• Mercy Medical Center-Centerville
• Mercy Medical Center-Centerville

• Family Medicine Physician in Centerville, IA
• Providers in Centerville, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.