NPIMap

Organization Active NPI

Petersburg Clinic Company, LLC

  • Family Medicine Physician
  • Colonial Heights, VA
National Provider Identifier
1528022506
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PETERSBURG CLINIC COMPANY, LLC
Practice address
436 Claremont CT
Suite 100
Colonial Heights, VA 23834-1765
Phone
(804) 526-2121
Fax
(804) 520-2617
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David L Miller
Title
Group VP
Phone
(866) 647-5069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

436 Claremont CT
Suite 100
Colonial Heights, VA 23834-1765

Mailing address

436 Claremont CT
Suite 100
Colonial Heights, VA 23834-1765
Phone (804) 526-2121

Other names 1

  • Health Care Plus Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Health Care Plus2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528022506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CLAREMONT CT",
            "address_2": "SUITE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341765",
            "telephone_number": "804-526-2121",
            "fax_number": "804-520-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CLAREMONT CT",
            "address_2": "SUITE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341765",
            "telephone_number": "804-526-2121",
            "fax_number": "804-520-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURG CLINIC COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "GROUP VP",
        "authorized_official_telephone_number": "866-647-5069",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Care Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.