Dickenson Medical Clinic PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DICKENSON MEDICAL CLINIC PC

Practice address

5607 Dickenson Highway
Clintwood, VA 24228

Phone

(276) 926-4601

Fax

(276) 926-4602

NPI assigned

Dec 13, 2006

Last updated

Mar 31, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rimon Ibrahim

Title

Owner

Phone

(276) 926-4601

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Taylor Rae Rowe, NP-C

  • Nurse Practitioner
  • Clintwood, VA
  • NPI 1326637927
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1851452411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2224",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242282224",
            "telephone_number": "276-926-4601",
            "fax_number": "276-926-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5607 DICKENSON HIGHWAY",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "24228",
            "telephone_number": "276-926-4601",
            "fax_number": "276-926-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKENSON MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "RIMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-926-4601"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010264995",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dickenson County Home Health and Hospice, Inc
• Dickenson County Home Medical Rentals, Inc
• Dickenson County Public Schools
• Dickenson Medical Associates a Department of Dickenson Community Hospi (BHRHC Dickenson)
• Dickenson Medical Clinic PC
• Dominion Health & Fitness, Inc
• Jana K Dreyzehner, MD
• Emcare Physician Providers Inc.
• Kristina Lynn Endicott, LPC
• Family Preservation Services, Inc

• Rural Health Clinic/Center in Clintwood, VA
• Providers in Clintwood, VA by specialty
• Rural Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.