Complete Care Medical Group LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101236987 Issued in VA

Legal business name

COMPLETE CARE MEDICAL GROUP LLC

Practice address

41 Peach Grove LN
Montross, VA 22520-2756

Phone

(804) 410-3322

Fax

(804) 627-0010

NPI assigned

Sep 1, 2016

Organization subpart

No

Name

Ms. Ashley K Williams

Title

Operations Manager

Phone

(804) 823-7707

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Robert Paulman, DC, PAC-C

  • Physician Assistant
  • Sayre, PA
  • NPI 1487951323
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 15, 2017.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1982151577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PEACH GROVE LN",
            "city": "MONTROSS",
            "state": "VA",
            "postal_code": "225202756",
            "telephone_number": "804-410-3322",
            "fax_number": "804-627-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PEACH GROVE LN",
            "city": "MONTROSS",
            "state": "VA",
            "postal_code": "225202756",
            "telephone_number": "804-410-3322",
            "fax_number": "804-627-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "804-823-7707",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101236987",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "010300694",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Virginia Health Services Inc
• Charles B. Palmer DDS
• Carlita Coley, LPC
• Colleen Collins, NP
• Commonwealth of Virginia State Board of Health
• Amanda Corcoran
• Roger Wayne Davis
• Heidi J Epp-Kapataidakis, FNP-BC
• Angela Noel Ernst, MD
• Yolanda Fisher

• All providers in Montross, VA
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.