NPIMap

Organization Active NPI

Front Royal Family Practice, P.C.

  • Family Medicine Physician
  • Front Royal, VA
National Provider Identifier
1750434072
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FRONT ROYAL FAMILY PRACTICE, P.C.
Practice address
140 W 11TH St
Front Royal, VA 22630-3512
Phone
(540) 631-3700
Fax
(540) 635-1673
NPI assigned
Jan 19, 2007
Last updated
Mar 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Mrs. Loretta Ysrael Gibson
Title
Practice Manager
Phone
(540) 631-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

140 W 11TH St
Front Royal, VA 22630-3512

Mailing address

140 W 11TH St
Front Royal, VA 22630-3512
Phone (540) 631-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051028000336 VA Part B Supplier - Clinic/Group Practice 2769409705 Receives reassigned benefits from 7 practitioners
Practice locations: Front Royal, VA

National Provider Directory

National Provider Directory

Locations

140 W 11th St
Front Royal, VA 22630
Phone (540) 631-3700

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1750434072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 11TH ST",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226303512",
            "telephone_number": "540-631-3700",
            "fax_number": "540-635-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W 11TH ST",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226303512",
            "telephone_number": "540-631-3700",
            "fax_number": "540-635-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT ROYAL FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_middle_name": "YSRAEL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "540-631-3700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Front Royal, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.