NPIMap

Organization Active NPI

Meadowcrest ENT and Facial Cosmetic Center

  • Otolaryngology Physician
  • Harrisonburg, VA
National Provider Identifier
1427266147
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0101037916 Issued in VA
Legal business name
MEADOWCREST ENT AND FACIAL COSMETIC CENTER
Practice address
3360 Emmaus Rd
Harrisonburg, VA 22801-2685
Phone
(540) 433-9399
Fax
(540) 433-1395
NPI assigned
May 18, 2007
Last updated
Feb 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Authorized official

Name
Dr. Charles Wayne Gates, M.D.NPI 1649263757
Title
Physician
Phone
(540) 433-9399

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101037916 VA Primary
Audiologist 231H00000X NU

Addresses

Primary practice location

3360 Emmaus Rd
Harrisonburg, VA 22801-2685

Mailing address

3360 Emmaus Rd
Harrisonburg, VA 22801-2685
Phone (540) 433-9399

Other identifiers 3

IdentifierTypeStateIssuer
462160OtherVAANTHEM ID
18364OtherVAOPTIMA ID
006503403MedicaidVA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1427266147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 EMMAUS RD",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012685",
            "telephone_number": "540-433-9399",
            "fax_number": "540-433-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 EMMAUS RD",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012685",
            "telephone_number": "540-433-9399",
            "fax_number": "540-433-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWCREST ENT AND FACIAL COSMETIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "540-433-9399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101037916",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "462160",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA ID",
            "identifier": "18364",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006503403",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; 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.