Board Certified Family Practice, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101045379 Issued in VA

Legal business name

BOARD CERTIFIED FAMILY PRACTICE, INC

Practice address

2020 S Independence Blvd Ste 3
Virginia Beach, VA 23453-4776

Phone

(757) 471-6977

Fax

(757) 471-5300

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Gautam Desai

Title

Owner

Phone

(757) 471-6977

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1972715274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S INDEPENDENCE BLVD STE 3",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234534776",
            "telephone_number": "757-471-6977",
            "fax_number": "757-471-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S INDEPENDENCE BLVD STE 3",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234534776",
            "telephone_number": "757-471-6977",
            "fax_number": "757-471-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD CERTIFIED FAMILY PRACTICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-471-6977"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101045379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890666E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005628881",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia S Blumenshine
• Karen M Blythe, COTA
• Philip Alan Blythe, D.D.S.
• Tressa O Blythe, PMHNP
• Sarah Smith Boadway
• Destiny Boardley
• Dennis Boateng, PHARM D
• Gregg M Boaz, D.C.
• Jeffrey Lorne Bobrowitz, MD
• Linda Vanessa Bocanegra English, DO

• Family Medicine Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.