Active NPI
Sugar Hollow Medical
- Family Medicine Physician
- Bristol, VA
National Provider Identifier
1972772929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101231449
- Legal business name
- SUGAR HOLLOW MEDICAL
- Practice address
- 3177 Linden Dr
Suite #6
Bristol, VA 24202-5812 - Phone
- (276) 466-3777
- Fax
- (276) 466-3705
- NPI assigned
- Feb 25, 2008
- 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
- Mr. David P Guldseth, MD
- Title
- President
- Phone
- (276) 466-3777
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101231449 | VA | Primary |
| Urgent Care Clinic/Center | 261QU0200X | 0101231449 | VA |
Addresses
Primary practice location
3177 Linden Dr
Suite #6
Bristol, VA 24202-5812
Mailing address
3177 Linden Dr
Suite #6
Bristol, VA 24202-5812
Phone (276) 466-3777
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4053485 | Other | BLUE CROSS -- TN | |
| 5629934 | Medicaid | VA | |
| 246144 | Other | VA | BLUE CROSS--VA |
| 00V083S29 | Other | VA | MEDICARE |
National Provider Directory
National Provider DirectoryLocations
3177 Linden Dr
Ste 6
Bristol, VA 24202
Phone (276) 466-3777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208217600000",
"number": "1972772929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3177 LINDEN DR",
"address_2": "SUITE #6",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242025812",
"telephone_number": "276-466-3777",
"fax_number": "276-466-3705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3177 LINDEN DR",
"address_2": "SUITE #6",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242025812",
"telephone_number": "276-466-3777",
"fax_number": "276-466-3705"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUGAR HOLLOW MEDICAL",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-25",
"last_updated": "2008-04-15",
"status": "A",
"authorized_official_last_name": "GULDSETH",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "276-466-3777",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "VA",
"license": "0101231449",
"primary": true
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "VA",
"license": "0101231449",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS -- TN",
"identifier": "4053485",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5629934",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS--VA",
"identifier": "246144",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "00V083S29",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.