Individual provider Active NPI

John Stuart Prince Jr., MD

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1619992005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101045813 Issued in VA
Practice address
1201 Broad Rock Blvd
Richmond, VA 23249-0001
Phone
(804) 675-5543
Fax
(804) 675-5028
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101045813 VA Primary

Addresses

Primary practice location

1201 Broad Rock Blvd
Richmond, VA 23249-0001

Mailing address

12004 Bellaverde Cir
Apt 203
Richmond, VA 23235-4386
Phone (804) 323-1965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000132 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8729265301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emporia Hospital Corporation Past Accepting new patients
Emporia Hospital Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619992005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12004 BELLAVERDE CIR",
            "address_2": "APT 203",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354386",
            "telephone_number": "804-323-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROAD ROCK BLVD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5543",
            "fax_number": "804-675-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "JOHN",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101045813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.