NPIMap

Organization Active NPI

Charlottesville Gastroenterology Associates PC

  • Specialist
  • Charlottesville, VA
National Provider Identifier
1689671448
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2953 Issued in VA
Legal business name
CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC
Practice address
1139 E High St
Suite 203
Charlottesville, VA 22902-4856
Phone
(434) 817-8484
Fax
(434) 817-8490
NPI assigned
Jul 7, 2005
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Dr. Byrd Stuart Leavell Jr., MDNPI 1386641157
Title
Owner
Phone
(434) 817-8484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2953 VA Primary

Addresses

Primary practice location

1139 E High St
Suite 203
Charlottesville, VA 22902-4856

Mailing address

1139 E High St
Suite 203
Charlottesville, VA 22902-4856
Phone (434) 817-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050412001064 VA Part B Supplier - Clinic/Group Practice 7214974195 Receives reassigned benefits from 18 practitioners
Practice locations: Charlottesville, VA

National Provider Directory

National Provider Directory

Locations

1139 E High St
Charlottesvle, VA 22902
Phone (434) 817-8484

1139 E High St
Ste 203
Charlottesvle, VA 22902
Phone (434) 817-8484

57 Beam Ln
Fishersville, VA 22939
Phone (540) 213-8484

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1689671448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 E HIGH ST",
            "address_2": "SUITE 203",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024856",
            "telephone_number": "434-817-8484",
            "fax_number": "434-817-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 E HIGH ST",
            "address_2": "SUITE 203",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024856",
            "telephone_number": "434-817-8484",
            "fax_number": "434-817-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTESVILLE GASTROENTEROLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "LEAVELL",
        "authorized_official_first_name": "BYRD",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-817-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "2953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.