NPIMap

Organization Active NPI

Dr. Jon's Urgent Care Center, LLC

  • General Practice Physician
  • Martinsville, VA
National Provider Identifier
1639403769
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DR. JON'S URGENT CARE CENTER, LLC
Practice address
2871 Greensboro Rd
Martinsville, VA 24112-8108
Phone
(276) 638-2273
Fax
(276) 638-2250
NPI assigned
Sep 22, 2009
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Dr. Jon Peterson, MDNPI 1407870975
Title
Director/Owner
Phone
(276) 638-2273

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

2871 Greensboro Rd
Martinsville, VA 24112-8108

Mailing address

2871 Greensboro Rd
Martinsville, VA 24112-8108
Phone (276) 638-2273

Other identifiers 1

IdentifierTypeStateIssuer
1639403769MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091110000452 VA Part B Supplier - Clinic/Group Practice 5294873378 Receives reassigned benefits from 12 practitioners
Practice locations: Martinsville, VA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11587/brand/1/csg/1/fhir/r4

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": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1639403769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128108",
            "telephone_number": "276-638-2273",
            "fax_number": "276-638-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 GREENSBORO RD",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241128108",
            "telephone_number": "276-638-2273",
            "fax_number": "276-638-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JON'S URGENT CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "276-638-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639403769",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.