Individual provider Active NPI

Christy Fagg Medeus, D.O.

  • Internal Medicine Physician
  • Blacksburg, VA
National Provider Identifier
1669637682
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102203117 Issued in VA
Practice address
3700 S Main St
Montgomery Hospitalist
Blacksburg, VA 24060-7017
Phone
(540) 953-5331
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116020704 VA
Internal Medicine Physician 207R00000X 0102203117 VA Primary

Addresses

Primary practice location

3700 S Main St
Montgomery Hospitalist
Blacksburg, VA 24060-7017

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other names 1

  • Dr. Christy Fagg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121024000852 VA Practitioner - Internal Medicine 3971753187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

200 Hospital Dr
Galax, VA 24333-2227
Phone (276) 236-8181

Hospital & facility affiliations

  • Twin County Regional Hospital Hospital, Galax, VA, CCN 490115
  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0116020704VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wildwood Physician Services, LLC CurrentSince Jul 3, 2018 Accepting new patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Sep 26, 2022 Accepting new patients
Kingsford Physician Services, LLC CurrentSince Jul 3, 2018 Accepting new patients
Montgomery Hospitalists LLC Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

3700 S Main St
Blacksburg, VA 24060
Phone (540) 951-1111

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

2400 Lee Hwy N
Pulaski, VA 24301
Phone (540) 994-8100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1669637682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S MAIN ST",
            "address_2": "MONTGOMERY HOSPITALIST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607017",
            "telephone_number": "540-953-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEUS",
        "first_name": "CHRISTY",
        "middle_name": "FAGG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116020704",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102203117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTY",
            "last_name": "FAGG",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.