NPIMap

Individual provider Active NPI

John Stephen Zachary, M.D.

  • Pediatric Adolescent Medicine Physician
  • Midlothian, VA
National Provider Identifier
1821133489
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
0101035226 Issued in VA
Practice address
1521 Huguenot Rd
Suite 101
Midlothian, VA 23113-2426
Phone
(804) 794-1072
Fax
(804) 794-5137
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X 0101035226 VA Primary

Addresses

Primary practice location

1521 Huguenot Rd
Suite 101
Midlothian, VA 23113-2426

Mailing address

1521 Huguenot Rd
Suite 101
Midlothian, VA 23113-2426
Phone (804) 794-1072

Other identifiers 7

IdentifierTypeStateIssuer
082365OtherVAANTHEM PROVIDER NUMBER
10012163OtherVAOPTIMA PROVIDER #
818403OtherVAMAMSI ALLIANCE PROV #
0000058166201OtherVAUNITED HEALTHCARE PROV#
276098OtherVASOUTHERN HEALTH PROV #
677345OtherVAAETNA PROVIDER NUMBER
0753949OtherVACIGNA PROVIDER #

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101035226VAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Partners of Virginia, LLC Single Specialty Past Accepting new patients
Pediatric Partners of Virginia, LLC Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jzachary@ppvkids.opdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821133489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 HUGUENOT RD",
            "address_2": "SUITE 101",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132426",
            "telephone_number": "804-794-1072",
            "fax_number": "804-794-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 HUGUENOT RD",
            "address_2": "SUITE 101",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231132426",
            "telephone_number": "804-794-1072",
            "fax_number": "804-794-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARY",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VA",
            "license": "0101035226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "082365",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA PROVIDER #",
            "identifier": "10012163",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI ALLIANCE PROV #",
            "identifier": "818403",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV#",
            "identifier": "0000058166201",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH PROV #",
            "identifier": "276098",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "677345",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "0753949",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.