Obici Medical Management Services, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101018926 Issued in VA

Legal business name

OBICI MEDICAL MANAGEMENT SERVICES, INC.

Doing business as

Wakefield Medical Center

Practice address

109 Railroad Avenue
Wakefield, VA 23434

Phone

(757) 899-3521

Fax

(757) 899-7104

NPI assigned

Jul 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Carpentar

Title

Sr VP-Cfo

Phone

(757) 934-4000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Wakefield Medical Center Doing business as

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720017379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348038",
            "telephone_number": "757-934-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RAILROAD AVENUE",
            "city": "WAKEFIELD",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "757-899-3521",
            "fax_number": "757-899-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBICI MEDICAL MANAGEMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARPENTAR",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "SR VP-CFO",
        "authorized_official_telephone_number": "757-934-4000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101018926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA/SENTARA",
            "identifier": "41033",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "323791",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA MEDICAID",
            "identifier": "263206",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wakefield Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Adkins Collier, FNP
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• Lisa V Hawkins
• Jennifer Clark Jones, CERTIFIED HAIR LOSS
• Sharon Dale Rogers, PH.D., ATC
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• Emanuel Montez Waddell
• Wakefield Pharmacy Inc (Wakefield Pharmacy)
• Carrie S Wiggins, FNPC

• Family Medicine Physician in Wakefield, VA
• Providers in Wakefield, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.