NPIMap

Organization Active NPI

Medexpress Urgent Care, PC - Virginia

Doing business as MedExpress Urgent Care - Hollins

  • Urgent Care Clinic/Center
  • Roanoke, VA
National Provider Identifier
1417211343
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDEXPRESS URGENT CARE, PC - VIRGINIA
Doing business as
MedExpress Urgent Care - Hollins
Practice address
5610 Williamson Rd
Roanoke, VA 24012-1442
Phone
(540) 265-8924
Fax
(540) 265-8928
NPI assigned
Jun 26, 2012
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Joy Kimball
Title
Contract Manager
Phone
(763) 349-6740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

5610 Williamson Rd
Roanoke, VA 24012-1442

Mailing address

423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500

Other identifiers 1

IdentifierTypeStateIssuer
1215219878MedicaidVA

Other names 1

  • MedExpress Urgent Care - Hollins Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111123000505 VA Part B Supplier - Clinic/Group Practice 3173797586 Receives reassigned benefits from 193 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, VA; Staunton, VA; Salem, VA; Roanoke, VA; Richmond, VA; Midlothian, VA; Martinsville, VA; Lynchburg, VA…

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Locations

1336 W Main St
Salem, VA 24153
Phone (540) 389-0374

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1417211343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BLVD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081351",
            "telephone_number": "304-225-2500",
            "fax_number": "304-985-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240121442",
            "telephone_number": "540-265-8924",
            "fax_number": "540-265-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEXPRESS URGENT CARE, PC - VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "763-349-6740"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215219878",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - Hollins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.