NPIMap

Organization Active NPI

Primedoc of Winchester PC

  • Internal Medicine Physician
  • Winchester, VA
National Provider Identifier
1396701173
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRIMEDOC OF WINCHESTER PC
Practice address
1840 Amherst St
Winchester, VA 22601-2808
Phone
(843) 237-3378
Fax
(843) 237-5073
NPI assigned
Apr 21, 2006
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Robert Reynolds, MDNPI 1861453383
Title
President
Phone
(828) 210-3260

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 Physician 207R00000X NU Primary

Addresses

Primary practice location

1840 Amherst St
Winchester, VA 22601-2808

Mailing address

PO Box 751406
Charlotte, NC 28275-1406
Phone (843) 237-3378

Other identifiers 3

IdentifierTypeStateIssuer
219017OtherVABLUE CROSS BLUE SHIELD
0204698000MedicaidWV
CH9829OtherVARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1396701173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751406",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751406",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEDOC OF WINCHESTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-210-3260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "219017",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0204698000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9829",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.