NPIMap

Organization Active NPI

Eventus WH Mid-Atlantic, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Midlothian, VA
National Provider Identifier
1700627130
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
EVENTUS WH MID-ATLANTIC, LLC
Practice address
250 Browns Hill CT
Midlothian, VA 23114-9510
Phone
(855) 743-2247
NPI assigned
May 31, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Bradley Goad, DONPI 1285617241
Title
Owner
Phone
(855) 743-2247

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary
Nurse Practitioner 363L00000X

Addresses

Primary practice location

250 Browns Hill CT
Midlothian, VA 23114-9510

Mailing address

PO Box 1431 Dept 405
Charlotte, NC 28201-1431

Other practice location 1

128 Capitol Street
Charleston, WV 25301-2610
Phone (855) 743-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240801002915 VA Part B Supplier - Clinic/Group Practice 7618414111 Receives reassigned benefits from 105 practitioners
Practice locations: Midlothian, VA
O20240923000206 WV Part B Supplier - Clinic/Group Practice 7618414111 Receives reassigned benefits from 6 practitioners
Practice locations: Charleston, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 106

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 106

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1700627130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1431 DEPT 405",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282011431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BROWNS HILL CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231149510",
            "telephone_number": "855-743-2247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Capitol Street",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253012610",
            "country_code": "US",
            "telephone_number": "855-743-2247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVENTUS WH MID-ATLANTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "GOAD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-743-2247",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.