NPIMap

Organization Active NPI

Commonwealth Primary Care

Doing business as Family Physicians, Wyndham

  • Family Medicine Physician
  • Glen Allen, VA
National Provider Identifier
1851464887
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMONWEALTH PRIMARY CARE
Doing business as
Family Physicians, Wyndham
Practice address
5360 Twin Hickory Rd
Glen Allen, VA 23059-5682
Phone
(804) 346-3200
Fax
(804) 346-4075
NPI assigned
Nov 16, 2006
Last updated
Sep 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Ms. Erika Parrish
Title
Billing Admin
Phone
(804) 288-0399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

5360 Twin Hickory Rd
Glen Allen, VA 23059-5682

Mailing address

1800 Glenside Dr
Suite 105
Richmond, VA 23226-3769
Phone (804) 288-0399

Other identifiers 2

IdentifierTypeStateIssuer
141466OtherVAANTHEM
CJ7063OtherVARAILROAD MEDICARE

Other names 1

  • Family Physicians, Wyndham Doing business as

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
49D0910159Family Physicians Wyndham5360 Twin Hickory Road, Glen Allen, VA 23059Certificate of waiverDec 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Med Assoc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

5360 Twin Hickory Rd
Glen Allen, VA 23059
Phone (804) 346-3200

Practitioners & affiliated clinicians

Practitioners 9

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1851464887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GLENSIDE DR",
            "address_2": "SUITE 105",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263769",
            "telephone_number": "804-288-0399",
            "fax_number": "804-285-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 TWIN HICKORY RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595682",
            "telephone_number": "804-346-3200",
            "fax_number": "804-346-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "PARRISH",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_title_or_position": "BILLING ADMIN",
        "authorized_official_telephone_number": "804-288-0399",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "141466",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ7063",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Physicians, Wyndham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.