NPIMap

Organization Active NPI

Pris, PLC

  • Physical Medicine & Rehabilitation Physician
  • Lynchburg, VA
National Provider Identifier
1982930673
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
0101055485 Issued in VA
Legal business name
PRIS, PLC
Practice address
1935 Thomson Dr
Lynchburg, VA 24501-1008
Phone
(434) 528-0896
Fax
(434) 528-0898
NPI assigned
Oct 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Authorized official

Name
Dr. Brenda Sue Waller, MDNPI 1093794133
Title
Ceo
Phone
(434) 528-0896

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 0101055485 VA Primary

Addresses

Primary practice location

1935 Thomson Dr
Lynchburg, VA 24501-1008

Mailing address

1935 Thomson Dr
Lynchburg, VA 24501-1008
Phone (434) 528-0896

Other identifiers 1

IdentifierTypeStateIssuer
010045100MedicaidVA

Other names 1

  • Brenda Waller Sole Member Other name

National Provider Directory

National Provider Directory

Locations

1935 Thomson Dr
Lynchburg, VA 24501
Phone (434) 528-0896

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1982930673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011008",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 THOMSON DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011008",
            "telephone_number": "434-528-0896",
            "fax_number": "434-528-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-528-0896",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101055485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010045100",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brenda Waller Sole Member",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 30, 2009; 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.