Blacksburg Pediatrics, PLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0102052848 Issued in VA

Legal business name

BLACKSBURG PEDIATRICS, PLC

Practice address

817 Davis St
Suite a
Blacksburg, VA 24060-7004

Phone

(540) 443-3940

Fax

(540) 443-3944

NPI assigned

Sep 27, 2016

Organization subpart

No

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

Authorized official

Name

David Edwin Berry, D.O, PH.D.NPI 1124082060

Title

Manager

Phone

(540) 443-3940

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David E Berry, D.O.

  • Pediatrics Physician
  • Blacksburg, VA
  • NPI 1124082060
  NPD (past) Authorized official

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1548719859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 DAVIS ST",
            "address_2": "SUITE A",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607004",
            "telephone_number": "540-443-3940",
            "fax_number": "540-443-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 DAVIS ST",
            "address_2": "SUITE A",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607004",
            "telephone_number": "540-443-3940",
            "fax_number": "540-443-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSBURG PEDIATRICS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "540-443-3940",
        "authorized_official_credential": "D.O, PH.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0102052848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blacksburg Orthopaedics, PC
• Blacksburg Pharmacy Inc (Blacksburg Pharmacy)
• Blacksburg Volunteer Rescue Squad
• Blacksburg Wellness Center, LLC
• Joseph Ryan Blanton, PTA
• Anna Blevins, LPTA

• Primary Care Clinic/Center in Blacksburg, VA
• Providers in Blacksburg, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.