Prince Squire Medical Center PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRINCE SQUIRE MEDICAL CENTER PC

Practice address

219 Weaver Avenue
Emporia, VA 23847

Phone

(434) 634-4148

Fax

(434) 634-6963

NPI assigned

Jul 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter Weaver Squire, MD

Title

Vice President

Phone

(434) 634-4148

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669496030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 WEAVER AVENUE",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "23847",
            "telephone_number": "434-634-4148",
            "fax_number": "434-634-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 WEAVER AVENUE",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "23847",
            "telephone_number": "434-634-4148",
            "fax_number": "434-634-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE SQUIRE MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SQUIRE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "WEAVER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "434-634-4148",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903779",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna M. Phipps, LCSW
• Constance Whittemore Poland
• Eugene Porter
• Bo Poulson, MD
• Kelli Miller Powell, FNP-C
• Rosemary Black Prince, RN
• Elfren A Quitiquit, MD
• Leanne Wiley Rawlings, FNP
• Tammy Rhodes
• Richmond Vamc

• Family Medicine Physician in Emporia, VA
• Providers in Emporia, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.