Wyndhurst Family Medicine, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101059194 Issued in VA

Legal business name

WYNDHURST FAMILY MEDICINE, P.C.

Practice address

102 Archway CT
Lynchburg, VA 24502-2889

Phone

(434) 237-3664

Fax

(434) 237-3711

NPI assigned

Oct 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Craig John Petry, M.D.NPI 1285657213

Title

Presid

Phone

(434) 237-3664

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

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

• Craig John Petry, M.D.

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1285657213
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1902095540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 ARCHWAY CT",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022889",
            "telephone_number": "434-237-3664",
            "fax_number": "434-237-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ARCHWAY CT",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022889",
            "telephone_number": "434-237-3664",
            "fax_number": "434-237-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDHURST FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESID",
        "authorized_official_telephone_number": "434-237-3664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101059194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "146316",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wenyao Wu
• Caroline H Wust, DPT
• Maranda Paige Wyckoff, PA-C
• Ruth E Wymer, CCC-SLP
• Wyndhurst Counseling Center, LLC
• Wyndhurst SNF Operations LLC
• Wynnes Adult Care Facility Inc
• Patrick J Wynnyk, M.D.
• Christina Metaxia Yanakis
• Brenda Markham Yarber, RN, BSN, CNNP

• Family Medicine Physician in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.