NPIMap

Organization Active NPI

New River Dermatology PLC

  • Dermatology Physician
  • Blacksburg, VA
National Provider Identifier
1467534248
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0102201003 Issued in VA
Legal business name
NEW RIVER DERMATOLOGY PLC
Practice address
2617 Sheffield Dr
Blacksburg, VA 24060-8271
Phone
(540) 953-2210
Fax
(540) 951-9112
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Daniel S Hurd, DONPI 1841290897
Title
Owner
Phone
(540) 953-2210

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 0102201003 VA Primary

Addresses

Primary practice location

2617 Sheffield Dr
Blacksburg, VA 24060-8271

Mailing address

2617 Sheffield Dr
Blacksburg, VA 24060-8271
Phone (540) 953-2210

Other identifiers 4

IdentifierTypeStateIssuer
01391200002OtherVAQUAL CHOICE
140785OtherVATRIGON
CH9865OtherVARR MEDICARE GROUP ID
5901928MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000580 VA Part B Supplier - Clinic/Group Practice 7416936570 Receives reassigned benefits from 11 practitioners
Practice locations: Blacksburg, VA; Wytheville, VA; Roanoke, VA; Radford, 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
49D0990271New River Dermatology2617 Sheffield Drive, Blacksburg, VA 24060ComplianceMay 1, 2026

National Provider Directory

National Provider Directory

Locations

3700 S Main St
Ste G
Blacksburg, VA 24060

2617 Sheffield Dr
Blacksburg, VA 24060
Phone (540) 953-2210

306 W Main St
Radford, VA 24141
Phone (540) 953-2210

710 W Ridge Rd
Ste 1D
Wytheville, VA 24382

146 W Main St
Wytheville, VA 24382
Phone (540) 953-2210

710 W Ridge Rd
Ste G
Wytheville, VA 24382
Phone (276) 339-2236

Practitioners & affiliated clinicians

Practitioners 12

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1467534248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 SHEFFIELD DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240608271",
            "telephone_number": "540-953-2210",
            "fax_number": "540-951-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 SHEFFIELD DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240608271",
            "telephone_number": "540-953-2210",
            "fax_number": "540-951-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW RIVER DERMATOLOGY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "HURD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-953-2210",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0102201003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUAL CHOICE",
            "identifier": "01391200002",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "140785",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP ID",
            "identifier": "CH9865",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901928",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.