Virginia Healthcare, PC
Organization Active NPI Geriatric Medicine (Family Medicine) Physician · Moseley, VA
NPI 1700445673 · NPPES record last updated Jun 13, 2019
Key facts
- NPI
- 1700445673
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- Legal business name
- VIRGINIA HEALTHCARE, PC
- Practice address
- 16313 Falconers Ter
Moseley, VA 23120-1655 - Phone
- (804) 554-6134
- Fax
- (804) 681-7102
- NPI assigned
- Jun 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Altory Musni Miranda Jr., MD
- Title
- Owner
- Phone
- (804) 554-6134
Practitioners 2
-
Stacy Lee Riedt, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110322000337 | VA | Part B Supplier - Clinic/Group Practice | 6002099546 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment Practice locations: Midlothian, VA; Richmond, VA; Moseley, VA; Madison, VA; Glen Allen, VA; Farmville, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | Yes | ||
| Geriatric Medicine (Internal Medicine) Physician |
207RG0300X |
Addresses
Primary practice location
16313 Falconers Ter
Moseley, VA 23120-1655
Mailing address
PO Box 17830
Richmond, VA 23226-7830
Phone (804) 554-6134
Other providers in Moseley, VA
- Gina White Thompson
- Remy Jones Thompson
- Monica Tremaglio
- Vandana Inc.
- Virginia CVS Pharmacy LLC
- Virginia Therapeutic Network LLC
- Petra Stockhaus White
All providers in Moseley, VA · Geriatric Medicine (Family Medicine) Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.