Organization Active NPI

Virginia Gastroenterology & Hepatology, Inc.

  • Gastroenterology Physician
  • Burke, VA
National Provider Identifier
1639355985
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101047013 Issued in VA
Legal business name
VIRGINIA GASTROENTEROLOGY & HEPATOLOGY, INC.
Practice address
9257 Old Keene Mill Rd
Burke, VA 22015-4202
Phone
(703) 455-5556
NPI assigned
Jan 17, 2008
Last updated
Feb 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Charles McBride, M.D.NPI 1831124197
Title
President
Phone
(703) 455-5556

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
Gastroenterology Physician 207RG0100X 0101047013 VA Primary

Addresses

Primary practice location

9257 Old Keene Mill Rd
Burke, VA 22015-4202

Mailing address

9257 Old Keene Mill Rd
Burke, VA 22015-4202

Other identifiers 1

IdentifierTypeStateIssuer
5851165MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041012000253 DC Part B Supplier - Clinic/Group Practice 5597725937 Receives reassigned benefits from 1 practitioner
Practice locations: Burke, VA

National Provider Directory

National Provider Directory

Locations

9257 Old Keene Mill Rd
Burke, VA 22015
Phone (703) 455-5556

Practitioners & affiliated clinicians

Practitioners 2

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": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1639355985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9257 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9257 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154202",
            "telephone_number": "703-455-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA GASTROENTEROLOGY & HEPATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-455-5556",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101047013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5851165",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.