NPIMap

Organization Active NPI

Mid-Atlantic Eldercare, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Woodlawn, VA
National Provider Identifier
1902094774
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
MID-ATLANTIC ELDERCARE, PLLC
Practice address
5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030
Phone
(276) 238-8876
Fax
(276) 238-8886
NPI assigned
Oct 5, 2007
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Dr. Bradley J Goad, DO
Title
Owner
Phone
(276) 238-8876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary

Addresses

Primary practice location

5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030

Mailing address

5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030
Phone (276) 238-8876

Other identifiers 1

IdentifierTypeStateIssuer
DN2980OtherGROUP PTAN

National Provider Directory

National Provider Directory

Locations

542 Allred Mill Rd
Mount Airy, NC 27030
Phone (336) 789-5076

Practitioners & affiliated clinicians

Practitioners 5

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": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1902094774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 CARROLLTON PIKE",
            "address_2": "SUITE B",
            "city": "WOODLAWN",
            "state": "VA",
            "postal_code": "243813030",
            "telephone_number": "276-238-8876",
            "fax_number": "276-238-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 CARROLLTON PIKE",
            "address_2": "SUITE B",
            "city": "WOODLAWN",
            "state": "VA",
            "postal_code": "243813030",
            "telephone_number": "276-238-8876",
            "fax_number": "276-238-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC ELDERCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "GOAD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-238-8876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "DN2980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlawn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.