NPIMap

Organization Active NPI

Samina Yousuf MD PC

  • Internal Medicine Physician
  • Lebanon, VA
National Provider Identifier
1598853889
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAMINA YOUSUF MD PC
Practice address
383 Highland Dr
Lebanon, VA 24266-4632
Phone
(276) 889-0433
Fax
(276) 889-5537
NPI assigned
Oct 11, 2006
Last updated
Nov 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Samina Yousuf, MDNPI 1275582389
Title
Owner
Phone
(276) 889-0433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

383 Highland Dr
Lebanon, VA 24266-4632

Mailing address

PO Box 128
Lebanon, VA 24266-0128
Phone (276) 889-0433

Other identifiers 10

IdentifierTypeStateIssuer
177346OtherVABLUE CROSS
382745OtherVABLUE CROSS
238285OtherVABLUE CROSS
248640OtherVABLUE CROSS
176423OtherVABLUE CROSS
384760OtherVABLUE CROSS
174348OtherVABLUE CROSS
174349OtherVABLUE CROSS
FEDERAL BLACK LUNGOtherVA01008700
248639OtherVABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902001305 VA Part B Supplier - Clinic/Group Practice 4880660604 Receives reassigned benefits from 10 practitioners
Practice locations: Castlewood, VA; Clintwood, VA; Lebanon, VA; Rosedale, VA

National Provider Directory

National Provider Directory

Locations

1201 N Wilcox Dr
Ste B
Kingsport, TN 37660
Phone (423) 247-7030

856 Clintwood Main St
Clintwood, VA 24228
Phone (276) 926-5220

142 Highland Dr
Lebanon, VA 24266
Phone (276) 880-3133

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1598853889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242660128",
            "telephone_number": "276-889-0433",
            "fax_number": "276-889-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 HIGHLAND DR",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664632",
            "telephone_number": "276-889-0433",
            "fax_number": "276-889-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMINA YOUSUF MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "YOUSUF",
        "authorized_official_first_name": "SAMINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-889-0433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "177346",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "382745",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "238285",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "248640",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "176423",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "384760",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "174348",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "174349",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01008700",
            "identifier": "FEDERAL BLACK LUNG",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "248639",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.