NPIMap

Organization Active NPI

John Randolph Family Practice LLC

  • Family Medicine Physician
  • Chester, VA
National Provider Identifier
1659330843
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHN RANDOLPH FAMILY PRACTICE LLC
Practice address
12900 Jefferson Davis Hwy
Chester, VA 23831-5311
Phone
(804) 414-0300
Fax
(804) 414-0319
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Carol Smith
Title
Vice President
Phone
(804) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12900 Jefferson Davis Hwy
Chester, VA 23831-5311

Mailing address

12900 Jefferson Davis Hwy
Chester, VA 23831-5311
Phone (804) 414-0300

Other identifiers 2

IdentifierTypeStateIssuer
DF58380OtherVARR MEDICARE
1659330843MedicaidVA

Other names 1

  • Chester Medical Group, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1659330843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 JEFFERSON DAVIS HWY",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238315311",
            "telephone_number": "804-414-0300",
            "fax_number": "804-414-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 JEFFERSON DAVIS HWY",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238315311",
            "telephone_number": "804-414-0300",
            "fax_number": "804-414-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN RANDOLPH FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-237-7760"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DF58380",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659330843",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chester Medical Group, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.