Bon Secours-Virginia Healthsource

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BON SECOURS-VIRGINIA HEALTHSOURCE

Doing business as

Blackstone Family Practice Center

Practice address

213 N Main St
Blackstone, VA 23824

Phone

(434) 292-7261

Fax

(434) 298-0908

NPI assigned

Jul 8, 2006

Last updated

Jul 27, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

BON SECOURS-VIRGINIA HEALTHSOURCEAs reported in NPPES

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

Authorized official

Name

George O Butler

Title

Executive Vice President

Phone

(804) 281-0271

Specialties & licenses 1

Addresses

Other names 1

• Blackstone Family Practice Center Doing business as

Part of

Ironbridge Family Pract

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1548293194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238241425",
            "telephone_number": "434-292-7261",
            "fax_number": "434-298-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "23824",
            "telephone_number": "434-292-7261",
            "fax_number": "434-298-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "804-281-0271"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackstone Family Practice Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blackstone Family Practice Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blackstone Life Care, LLC (Heritage Hall - Blackstone)
• Blackstone Physical Therapy LLC
• Blackstone Vol.Fire Dept
• Bon Secours St. Francis Medical Center, Inc. (Blackstone Family Practice Center)
• Bon Secours St. Francis Medical Center, Inc. (Blackstone Family Practice Center)
• James L. Bradshaw, DDS
• Jennifer Bunn, LPC
• Janet C Bunnell, MS CCC-SLP
• Christopher Jacob Ciccone Jr., DO
• Chandra H. Clark, RN, CDCES

• Family Medicine Physician in Blackstone, VA
• Providers in Blackstone, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.