NPIMap

Organization Active NPI

CHS Virginia Medical, PC

Doing business as Goodlife Health Center

  • General Practice Physician
  • Danville, VA
National Provider Identifier
1689096778
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CHS VIRGINIA MEDICAL, PC
Doing business as
Goodlife Health Center
Practice address
1901 Goodyear Blvd
Danville, VA 24541-6607
Phone
(434) 791-9262
NPI assigned
Jan 9, 2014
Last updated
Jan 9, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
CHS HEALTH SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Authorized official

Name
Stuart Clark
Title
Executive VP
Phone
(706) 760-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1901 Goodyear Blvd
Danville, VA 24541-6607

Mailing address

5500 Maryland Way Ste 200
Brentwood, TN 37027-4973

Other names 1

  • Goodlife Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Virginia Medical PC23 organizations share this tax ID, including this one
Part of
Choose Health Wellness Ctr

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1689096778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 GOODYEAR BLVD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245416607",
            "telephone_number": "434-791-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS VIRGINIA MEDICAL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS HEALTH SERVICES, LLC",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "706-760-0700"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodlife Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.