Valdese Family Practice, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

79330 Issued in NC

Legal business name

VALDESE FAMILY PRACTICE, PA

Practice address

99 Griffin Street
Rutherford College, NC 28671

Phone

(828) 874-1316

Fax

(828) 874-1092

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Paula B Walker

Title

Office Manager

Phone

(828) 874-1316

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Allen Arensman, MD

  • Family Medicine Physician
  • Rutherford College, NC
  • NPI 1528157690
  Medicare reassignment Care Compare group NPD
• Kerry Wendell Byrd, MD

  • Family Medicine Physician
  • Rutherford College, NC
  • NPI 1932298007
  Medicare reassignment Care Compare group NPD
• Joanna Marie Dymora, DNP, FNP-BC

  • Family Nurse Practitioner
  • Marion, NC
  • NPI 1861053001

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1720104540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 GRIFFIN STREET",
            "address_2": "PO BOX 806",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "28671",
            "telephone_number": "828-874-1316",
            "fax_number": "828-874-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 GRIFFIN STREET",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "28671",
            "telephone_number": "828-874-1316",
            "fax_number": "828-874-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDESE FAMILY PRACTICE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-874-1316"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "79330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890195J",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BCBS GROUP NUMBER",
            "identifier": "0195J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarvesh Rao Sathiraju, M.D.
• Michael Skolochenko, MD
• Nickolas Sprinkle, PHARMD
• Robert Angel Stevenson, DDS
• Brandon Shane Tolbert
• Micah Loren Wilson, NP-C
• Women'S Health Care,P.a.
• Jamie Young, M.D., PHD

• Family Medicine Physician in Rutherford College, NC
• Providers in Rutherford College, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.