Organization Active NPI

Rockbridge Medical Group, Inc

  • Family Medicine Physician
  • Lexington, VA
National Provider Identifier
1992889356
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROCKBRIDGE MEDICAL GROUP, INC
Practice address
204 E Washington St
Lexington, VA 24450-2718
Phone
(540) 463-5055
Fax
(540) 463-1079
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Ashley Burnett-Davis
Title
Insurance
Phone
(540) 463-5055

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

204 E Washington St
Lexington, VA 24450-2718

Mailing address

204 E Washington St
Lexington, VA 24450-2718
Phone (540) 463-5055

Other identifiers 1

IdentifierTypeStateIssuer
1992889356MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000092 VA Part B Supplier - Clinic/Group Practice 3971520404 Receives reassigned benefits from 4 practitioners
Practice locations: Lexington, VA

National Provider Directory

National Provider Directory

Locations

204 E Washington St
Lexington, VA 24450
Phone (540) 462-7384

Practitioners & affiliated clinicians

Practitioners 7

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1992889356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E WASHINGTON ST",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502718",
            "telephone_number": "540-463-5055",
            "fax_number": "540-463-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E WASHINGTON ST",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244502718",
            "telephone_number": "540-463-5055",
            "fax_number": "540-463-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKBRIDGE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "BURNETT-DAVIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "540-463-5055"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992889356",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.