Active NPI
Pulaski Urology LLC
- Urology Physician
- Pulaski, VA
National Provider Identifier
1942226840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- PULASKI UROLOGY LLC
- Practice address
- 2460 Lee Hwy N
Suite 5
Pulaski, VA 24301-2335 - Phone
- (540) 980-3914
- Fax
- (540) 980-9595
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Washington
- Title
- VP
- Phone
- (703) 650-2907
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
2460 Lee Hwy N
Suite 5
Pulaski, VA 24301-2335
Mailing address
2460 Lee Hwy N
Suite 5
Pulaski, VA 24301-2335
Phone (540) 980-3914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942226840 | Medicaid | VA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Urology Physician
- Pulaski, VA
- NPI 1780615377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200009600000",
"number": "1942226840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 LEE HWY N",
"address_2": "SUITE 5",
"city": "PULASKI",
"state": "VA",
"postal_code": "243012335",
"telephone_number": "540-980-3914",
"fax_number": "540-980-9595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 LEE HWY N",
"address_2": "SUITE 5",
"city": "PULASKI",
"state": "VA",
"postal_code": "243012335",
"telephone_number": "540-980-3914",
"fax_number": "540-980-9595"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PULASKI UROLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-14",
"last_updated": "2008-01-11",
"status": "A",
"authorized_official_last_name": "WASHINGTON",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "703-650-2907"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1942226840",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pulaski, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.