Organization Active NPI

Old Hampton Family Medical Associates, P.C.

  • Family Medicine Physician
  • Hampton, VA
National Provider Identifier
1912035916
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OLD HAMPTON FAMILY MEDICAL ASSOCIATES, P.C.
Practice address
26 Wine St
Hampton, VA 23669-3584
Phone
(757) 728-1100
Fax
(757) 728-0870
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Ms. Ann Shaw
Title
Office Manager
Phone
(757) 728-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

26 Wine St
Hampton, VA 23669-3584

Mailing address

26 Wine St
Hampton, VA 23669-3584
Phone (757) 728-1100

Other identifiers 2

IdentifierTypeStateIssuer
5637341MedicaidVA
005114OtherVAANTHEM

National Provider Directory

National Provider Directory

Locations

26 Wine St
Hampton, VA 23669
Phone (757) 728-1100

Practitioners & affiliated clinicians

Practitioners 1

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": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1912035916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WINE ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693584",
            "telephone_number": "757-728-1100",
            "fax_number": "757-728-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 WINE ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693584",
            "telephone_number": "757-728-1100",
            "fax_number": "757-728-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD HAMPTON FAMILY MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-728-1100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5637341",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "005114",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.