Individual provider Active NPI

Thomas Bundrick, M.D.

  • Diagnostic Radiology Physician
  • Harrisonburg, VA
National Provider Identifier
1780623041
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101034066 Issued in VA
Practice address
2010 Health Campus Drive
Harrisonburg, VA 22801-3248
Phone
(540) 689-1000
Fax
(540) 434-0550
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101034066 VA Primary

Addresses

Primary practice location

2010 Health Campus Drive
Harrisonburg, VA 22801-3248

Mailing address

370 Neff Ave
Harrisonburg, VA 22801-3439
Phone (540) 432-8950

Other identifiers 1

IdentifierTypeStateIssuer
7264909MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101034066VAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1780623041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 NEFF AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013439",
            "telephone_number": "540-432-8950",
            "fax_number": "540-434-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 HEALTH CAMPUS DRIVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013248",
            "telephone_number": "540-689-1000",
            "fax_number": "540-434-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDRICK",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101034066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7264909",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.