NPIMap

Organization Active NPI

Wythe County Physician Practices LLC

  • Rural Health Clinic/Center
  • Max Meadows, VA
National Provider Identifier
1831838283
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WYTHE COUNTY PHYSICIAN PRACTICES LLC
Practice address
791 Fort Chiswell Rd
Max Meadows, VA 24360-4139
Phone
(276) 637-6641
Fax
(276) 637-6741
NPI assigned
Jun 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

791 Fort Chiswell Rd
Max Meadows, VA 24360-4139

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Wythe Physician Practices Family Care & Women's Health - Fort Chiswell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060209000451 VA Part B Supplier - Clinic/Group Practice 7517972789 Receives reassigned benefits from 59 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wytheville, VA; Galax, VA; Rural Retreat, VA; Max Meadows, VA
O20220912003806 VA Part A Provider - Rural Health Clinic 7517972789 Practice locations: Max Meadows, VA

Rural health clinic certification: CCN 498939

Legal name
WYTHE COUNTY PHYSICIAN PRACTICES LLC
Doing business as
WYTHE PHYSICIAN PRACTICES - FAMILY CARE & WOMEN'S HEALTH FORT CHISWELL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 30, 2023
Last certification
Mar 30, 2023
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Jul 28, 2005 in DE
Enrollment address
791 Fort Chiswell Rd
Max Meadows, VA 24360-4139

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
49D2009965Wythe Physician Practices-Family Care791 Fort Chiswell Road - Suite a, Max Meadows, VA 24360Certificate of waiverJul 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wythe County Physician Practices3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lifepoint Holdings 2 LLC Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest Nov 16, 2018 100%
Pamela Kane Individual Corporate OfficerVice President Aug 9, 2022
DSB Acquisition LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Laura C Hinson Individual Corporate OfficerChief Financial Officer Mar 12, 2025
Lifepoint Hospitals Holdings LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Historic Lifepoint Hospitals, LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Charlotte E Lawrence Individual Corporate OfficerSecretary Jan 21, 2022
Klaus Michael Boel Individual Corporate OfficerPresident Aug 19, 2024
W-2 Managing Employee Aug 19, 2024
John Michael Grooms Individual Corporate OfficerSr Vice President | Treasurer Nov 16, 2018
Christopher J Monte Individual Corporate OfficerVice President Nov 16, 2018
Legacy Lifepoint Health LLC Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1831838283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 FORT CHISWELL RD",
            "city": "MAX MEADOWS",
            "state": "VA",
            "postal_code": "243604139",
            "telephone_number": "276-637-6641",
            "fax_number": "276-637-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYTHE COUNTY PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wythe Physician Practices Family Care & Women's Health - Fort Chiswell",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wythe Physician Practices Family Care & Women's Health - Fort Chiswell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Max Meadows, VA

Sources for this page

Verify at the official NPI Registry.