Organization Active NPI

Wiggington Road Family Practice Inc

  • General Practice Physician
  • Lynchburg, VA
National Provider Identifier
1942396908
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WIGGINGTON ROAD FAMILY PRACTICE INC
Practice address
113 Wiggington Road
Lynchburg, VA 24502
Phone
(434) 385-7578
Fax
(434) 385-9756
NPI assigned
Oct 5, 2006
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Alan M. Podoseh, M.D.
Title
Medical Doctor
Phone
(434) 385-7578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

113 Wiggington Road
Lynchburg, VA 24502

Mailing address

113 Wiggington Road
Lynchburg, VA 24502
Phone (434) 385-7578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000433 VA Part B Supplier - Clinic/Group Practice 3870559396 Receives reassigned benefits from 5 practitioners
Practice locations: Lynchburg, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0232957Wiggington Road Family Practice113 Wiggington Road, Lynchburg, VA 24502Provider-performed microscopyJun 16, 2027

National Provider Directory

National Provider Directory

Locations

113 Wiggington Rd
Lynchburg, VA 24502
Phone (434) 385-7578

113 Wiggington Rd
Ste A
Lynchburg, VA 24502
Phone (434) 385-7578

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1942396908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WIGGINGTON ROAD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24502",
            "telephone_number": "434-385-7578",
            "fax_number": "434-385-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WIGGINGTON ROAD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "24502",
            "telephone_number": "434-385-7578",
            "fax_number": "434-385-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIGGINGTON ROAD FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "PODOSEH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "434-385-7578",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.