NPIMap

Organization Active NPI

Alliance Family Practice, PC

  • Adult Health Nurse Practitioner
  • Petersburg, VA
National Provider Identifier
1457378804
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024131004 Issued in VA
Legal business name
ALLIANCE FAMILY PRACTICE, PC
Practice address
3333 S Crater Rd
Suite 3a
Petersburg, VA 23805-9276
Phone
(804) 733-3438
Fax
(804) 733-7424
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Authorized official

Name
Mrs. Alfreda Booker
Title
Billing Manager
Phone
(804) 323-5575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X 0024131004 VA Primary

Addresses

Primary practice location

3333 S Crater Rd
Suite 3a
Petersburg, VA 23805-9276

Mailing address

3333 S Crater Rd
Suite 3a
Petersburg, VA 23805-9276
Phone (804) 733-3438

Other identifiers 1

IdentifierTypeStateIssuer
0024131004OtherVASTATE ID

National Provider Directory

National Provider Directory
Tax ID family
Alliance Family Health Care PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3333 S Crater Rd
Ste 3A
Petersburg, VA 23805
Phone (804) 733-3438

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1457378804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S CRATER RD",
            "address_2": "SUITE 3A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059276",
            "telephone_number": "804-733-3438",
            "fax_number": "804-733-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S CRATER RD",
            "address_2": "SUITE 3A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059276",
            "telephone_number": "804-733-3438",
            "fax_number": "804-733-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "ALFREDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "804-323-5575",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024131004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "0024131004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.