NPIMap

Organization Active NPI

Embrey Mill Primary and Urgent Care LLC

  • General Practice Physician
  • Stafford, VA
National Provider Identifier
1790400042
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EMBREY MILL PRIMARY AND URGENT CARE LLC
Practice address
1610 Publix Way # B112
Stafford, VA 22554-7783
Phone
(571) 332-2439
NPI assigned
Oct 10, 2022
Last updated
Nov 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Galam A KhanNPI 1952628034
Title
Authorized Official
Phone
(571) 332-2439

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1610 Publix Way # B112
Stafford, VA 22554-7783

Mailing address

1610 Publix Way # B112
Stafford, VA 22554-7783

National Provider Directory

National Provider Directory

Locations

1610 Publix Way
Ste 112
Stafford, VA 22554
Phone (571) 332-2439

Practitioners & affiliated clinicians

Practitioners 7

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": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1790400042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PUBLIX WAY # B112",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PUBLIX WAY # B112",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547783",
            "telephone_number": "571-332-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBREY MILL PRIMARY AND URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "GALAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "571-332-2439"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.