Organization Active NPI

Mechanicsville Medical Center Family Physicians, P.L.L.C.

  • Family Medicine Physician
  • Mechanicsville, VA
National Provider Identifier
1386716249
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MECHANICSVILLE MEDICAL CENTER FAMILY PHYSICIANS, P.L.L.C.
Practice address
7571 Cold Harbor Rd
Mechanicsville, VA 23111-1631
Phone
(804) 746-9055
Fax
(804) 746-4476
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ronald R Eagle
Title
Financial Manager
Phone
(804) 746-9055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7571 Cold Harbor Rd
Mechanicsville, VA 23111-1631

Mailing address

7571 Cold Harbor Rd
Mechanicsville, VA 23111-1631
Phone (804) 746-9055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000824 VA Part B Supplier - Clinic/Group Practice 7810965175 Receives reassigned benefits from 4 practitioners
Practice locations: Mechanicsville, VA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0226335Mechanicsville Medical Center7571 Cold Harbor Road, Mechanicsville, VA 23111Certificate of waiverFeb 18, 2028

National Provider Directory

National Provider Directory

Locations

7571 Cold Harbor Rd
Bldg 1
Mechanicsville, VA 23111

7571 Cold Harbor Rd
Mechanicsvlle, VA 23111
Phone (804) 746-9055

Practitioners & affiliated clinicians

Practitioners 4

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386716249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7571 COLD HARBOR RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111631",
            "telephone_number": "804-746-9055",
            "fax_number": "804-746-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7571 COLD HARBOR RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111631",
            "telephone_number": "804-746-9055",
            "fax_number": "804-746-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECHANICSVILLE MEDICAL CENTER FAMILY PHYSICIANS, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EAGLE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "804-746-9055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.