NPIMap

Organization Active NPI

Mid Atlantic Health Specialists PC

  • Gastroenterology Physician
  • Galax, VA
National Provider Identifier
1619938024
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101041026 Issued in VA
Legal business name
MID ATLANTIC HEALTH SPECIALISTS PC
Practice address
103 Doctors Park
Galax, VA 24333-2277
Phone
(276) 236-2947
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Robert Benish
Title
President
Phone
(276) 236-2947

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 0101057515 VA
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X 0101041026 VA Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 0110001464 VA
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 0024103947 VA

Addresses

Primary practice location

103 Doctors Park
Galax, VA 24333-2277

Mailing address

103 Doctors Park
Galax, VA 24333-2277
Phone (276) 236-2947

Other identifiers 2

IdentifierTypeStateIssuer
890249MMedicaidNC
226464OtherVABCBS

National Provider Directory

National Provider Directory
Tax ID family
Mid Atlantic Health Specialists Health PC2 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": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1619938024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 DOCTORS PARK",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332277",
            "telephone_number": "276-236-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 DOCTORS PARK",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332277",
            "telephone_number": "276-236-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC HEALTH SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "BENISH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "276-236-2947"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101057515",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101041026",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001464",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024103947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890249M",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "226464",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.