Watauga Recovery Center Wytheville

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

0101041174 Issued in VA

Legal business name

WATAUGA RECOVERY CENTER WYTHEVILLE

Practice address

255 Holston Rd
Wytheville, VA 04382-4448

Phone

(276) 227-0206

Fax

(276) 227-0856

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Betty C Linke

Title

Executive Assistant

Phone

(423) 631-0432

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1952852261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HOLSTON RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824448",
            "telephone_number": "276-227-0206",
            "fax_number": "276-227-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HOLSTON RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "043824448",
            "telephone_number": "276-227-0206",
            "fax_number": "276-227-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATAUGA RECOVERY CENTER WYTHEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "LINKE",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "423-631-0432",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "VA",
            "license": "0101041174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Addiction Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.