Uva Community Health Medical Group, LLC
Organization Active NPI Family Medicine Physician · Haymarket, VA
NPI 1649948290 · NPPES record last updated Sep 26, 2023
Key facts
- NPI
- 1649948290
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- UVA COMMUNITY HEALTH MEDICAL GROUP, LLC
- Practice address
- 15195 Heathcote Blvd Ste 140
Haymarket, VA 20169-6243 - Phone
- (571) 284-4370
- Fax
- (571) 284-4387
- NPI assigned
- Aug 31, 2021
- Organization subpart
- No
Authorized official
- Name
- Chuck D Coder
- Title
- Cfo
- Phone
- (804) 835-2069
Corporate family (same tax ID) 41
Practitioners 8
-
Samantha L Diehl, PA
-
Manoj Kumar, M.D., MPH
-
Terrance Lamont Pyles, M.D.
-
Francis X Ratchford, M.D.
-
Andrew C. Schomer, M.D.
-
Matthew C Cole, PA-C
-
Sandeep Saran, D.O
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2067133 | Uva Health Bull Run Family Medicine Haymarket | Certificate of waiver | Oct 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110311000151 | VA | Part B Supplier - Clinic/Group Practice | 4688587967 |
Receives reassigned benefits from 608 practitioners This NPI is an additional NPI on the enrollment Practice locations: Manassas, VA; Haymarket, VA; Keswick, VA; Prince William, VA; Richmond, VA; South Riding, VA; Warrenton, VA; Winchester, VA… |
National Provider Directory
- Tax ID family
- NMG Affilate Practice I LLC
Locations
15195 Heathcote Blvd
Ste 140
Haymarket, VA 20169
Phone (571) 284-4370
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Hematology & Oncology Physician |
207RH0003X |
Addresses
Primary practice location
15195 Heathcote Blvd Ste 140
Haymarket, VA 20169-6243
Mailing address
PO Box 748613
Atlanta, GA 30384-8613
Other names
- UVA Health Bull Run Family Medicine Haymarket
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Haymarket, VA
- Urgent Behavioral Health Services, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Community Health Medical Group, LLC
- Uva Prince William Medical Center
- Maricarmen Vendrell - Henson
All providers in Haymarket, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.