Pioneer Health Services of Patrick County, Inc

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

H1919 Issued in VA

Legal business name

PIONEER HEALTH SERVICES OF PATRICK COUNTY, INC

Practice address

18688 Jeb Stuart Hwy
Stuart, VA 24171-1559

Phone

(276) 694-8600

Fax

(276) 694-8679

NPI assigned

Apr 10, 2009

Last updated

Apr 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph S McNulty III

Title

Ceo

Phone

(601) 849-6440

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1366685018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 8TH AVE SW",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391113967",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18688 JEB STUART HWY",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711559",
            "telephone_number": "276-694-8600",
            "fax_number": "276-694-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF PATRICK COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-10",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "H1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ER",
            "identifier": "362626",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982858585",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PCH Operations, LLC Dba R.J. Reynolds-Patrick County Memorial Hospital
• PCH Operations, LLC Dba R.J. Reynolds-Patrick County Memorial Hospital
• PCH Operations, LLC Dba RJ Reynolds-Patrick County Memorial Hospital
• Peaceful Restoration Behavioral Health LLC
• Pioneer Health Servces of Patrick County, Inc. (Pioneer Family Medical)
• Pioneer Health Services of Patrick County, Inc
• Pioneer Health Services of Patrick County, Inc.
• Nichole Dawn Pruitt
• Quiet Oak LLC
• Meagan Nichole Radford, FNP-BC

• Emergency Medicine Physician in Stuart, VA
• Providers in Stuart, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2009; 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.