Organization Active NPI

Women's Health Center of Swva LLC

  • Obstetrics & Gynecology Physician
  • Pulaski, VA
National Provider Identifier
1508030081
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMEN'S HEALTH CENTER OF SWVA LLC
Practice address
101 1St St NW
Suite 1
Pulaski, VA 24301-5603
Phone
(540) 980-9170
Fax
(540) 980-9175
NPI assigned
Apr 16, 2008
Last updated
Jul 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Authorized official

Name
William Tedrick John
Title
VP
Phone
(804) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

101 1St St NW
Suite 1
Pulaski, VA 24301-5603

Mailing address

101 1St St NW
Suite 1
Pulaski, VA 24301-5603
Phone (540) 980-9170

Other identifiers 1

IdentifierTypeStateIssuer
1508030081MedicaidVA

National Provider Directory

National Provider Directory

Locations

101 1st St NW
Ste 1
Pulaski, VA 24301
Phone (540) 980-2844

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1508030081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 1ST ST NW",
            "address_2": "SUITE 1",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243015603",
            "telephone_number": "540-980-9170",
            "fax_number": "540-980-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 1ST ST NW",
            "address_2": "SUITE 1",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243015603",
            "telephone_number": "540-980-9170",
            "fax_number": "540-980-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S HEALTH CENTER OF SWVA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "804-237-7760"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508030081",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.