NPIMap

Organization Active NPI

PCH Express Care Clinic

  • Rural Health Clinic/Center
  • Stuart, VA
National Provider Identifier
1588717219
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
H1919 Issued in VA
Legal business name
PCH EXPRESS CARE CLINIC
Practice address
18688 Jeb Stuart Hwy
Stuart, VA 24171-1559
Phone
(276) 694-3151
Fax
(276) 694-8655
NPI assigned
Jan 18, 2007
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mrs. Janice F. Wilkins
Title
Administrator
Phone
(276) 694-8678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H1919 VA Primary

Addresses

Primary practice location

18688 Jeb Stuart Hwy
Stuart, VA 24171-1559

Mailing address

18688 Jeb Stuart Hwy
Stuart, VA 24171-1559
Phone (276) 694-3151

Other identifiers 3

IdentifierTypeStateIssuer
330049OtherVAMAMSI
010135583MedicaidVA
146602OtherVAANTHEM

National Provider Directory

National Provider Directory
Tax ID family
PCH Operations LLC Dba RJ Reynolds-Patrick County Memorial Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1588717219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18688 JEB STUART HWY",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711559",
            "telephone_number": "276-694-3151",
            "fax_number": "276-694-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18688 JEB STUART HWY",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711559",
            "telephone_number": "276-694-3151",
            "fax_number": "276-694-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCH EXPRESS CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "276-694-8678",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "VA",
            "license": "H1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "330049",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010135583",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "146602",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.