Organization Active NPI

Pulaski Urology LLC

  • Urology Physician
  • Pulaski, VA
National Provider Identifier
1942226840
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
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

Updated by the provider on Jan 11, 2008

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1942226840MedicaidVA

National Provider Directory

National Provider Directory

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": "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.

Verify at the official NPI Registry.