Organization Active NPI

Redbud Family Medicine

  • Family Medicine Physician
  • Honaker, VA
National Provider Identifier
1760959357
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REDBUD FAMILY MEDICINE
Practice address
5296 Redbud Hwy
Honaker, VA 24260-7379
Phone
(276) 991-9500
Fax
(276) 991-4399
NPI assigned
Nov 1, 2018
Last updated
Nov 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Authorized official

Name
Vickie Lynne Stevens, FNPNPI 1891206645
Title
Owner
Phone
(276) 730-5782

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5296 Redbud Hwy
Honaker, VA 24260-7379

Mailing address

1048 Terrace Dr
Marion, VA 24354-4138
Phone (276) 783-1827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181212003633 VA Part B Supplier - Clinic/Group Practice 7517202930 Receives reassigned benefits from 2 practitioners
Practice locations: Honaker, VA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2157199Redbud Family Medicine5296 Redbud Highway, Honaker, VA 24260Certificate of waiverOct 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1760959357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 TERRACE DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544138",
            "telephone_number": "276-783-1827",
            "fax_number": "276-783-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5296 REDBUD HWY",
            "city": "HONAKER",
            "state": "VA",
            "postal_code": "242607379",
            "telephone_number": "276-991-9500",
            "fax_number": "276-991-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDBUD FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-730-5782",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honaker, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.