Vance Family Medcine PA

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

36447 Issued in NC

Legal business name

VANCE FAMILY MEDCINE PA

Practice address

381 Ruin Creek Rd
Henderson, NC 27536-2932

Phone

(252) 430-0666

NPI assigned

Aug 21, 2014

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• Vance Family Medicine Doing business as

Part of

Tri - State Medical Group Inc

Locations

Practitioners 1

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

• Khanh Tuan Vu, M.D.

  • Family Medicine Physician
  • Henderson, NC
  • NPI 1679570717
  NPD (past)

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1922407477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362932",
            "telephone_number": "252-430-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCE FAMILY MEDCINE PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NC",
            "license": "36447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vance Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vance County Schools
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• Vance Family Life Services Inc,
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• Vance Recovery, PC
• Vance Recovery, PC
• Vance Recovery, PC

• Non-Pharmacy Dispensing Site in Henderson, NC
• Providers in Henderson, NC by specialty
• Non-Pharmacy Dispensing Site in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.