Organization Active NPI

Internal Medicine of Williamsburg, Inc.

  • Internal Medicine Physician
  • Williamsburg, VA
National Provider Identifier
1366622326
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101232252 Issued in VA
Legal business name
INTERNAL MEDICINE OF WILLIAMSBURG, INC.
Practice address
227 McLaws Cir
Williamsburg, VA 23185-5649
Phone
(757) 564-8182
Fax
(757) 564-0077
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Dr. David Gordon Hundt, M.D.NPI 1053311613
Title
President
Phone
(757) 564-8182

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0101232252 VA Primary

Addresses

Primary practice location

227 McLaws Cir
Williamsburg, VA 23185-5649

Mailing address

227 McLaws Cir
Williamsburg, VA 23185-5649
Phone (757) 564-8182

Other identifiers 1

IdentifierTypeStateIssuer
C09008OtherVAMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511000898 VA Part B Supplier - Clinic/Group Practice 2668461930 Receives reassigned benefits from 2 practitioners
Practice locations: Williamsburg, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1366622326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MCLAWS CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855649",
            "telephone_number": "757-564-8182",
            "fax_number": "757-564-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MCLAWS CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855649",
            "telephone_number": "757-564-8182",
            "fax_number": "757-564-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF WILLIAMSBURG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "HUNDT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-564-8182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101232252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "C09008",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.