MARTHA JEFFERSON MEDICAL GROUP LLC (NPI# 1275720559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275720559 |
| Entity Type | Organization |
| Organization Name | MARTHA JEFFERSON MEDICAL GROUP LLC |
| Practice Address |
590 Peter Jefferson Pkwy Ste 300 Charlottesville VA 22911-4628 |
| Mailing Address |
Po Box 79777 Baltimore MD 21279-0777 |
| Practice Telephone | 4346547794 |
| Practice Fax Number | 4346547752 |
| Mailing Telephone | 4346547794 |
| Mailing Fax Number | 4346547752 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2017-10-02 |
| Authorized Official Name | JOSEPH MICHAEL BURRIS (VICE PRESIDENT CHIEF FINANCIAL OFF) |
| Authorized Official Telephone | 4346547794 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARTHA JEFFERSON HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
VA | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | VA | Allopathic & Osteopathic Physicians | |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
VA | Allopathic & Osteopathic Physicians | |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | VA | Allopathic & Osteopathic Physicians | |
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
VA | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | VA | Allopathic & Osteopathic Physicians | |
| N | 208200000X | Plastic Surgery | VA | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | VA | Allopathic & Osteopathic Physicians | |
| N | 208M00000X | Hospitalist | VA | Allopathic & Osteopathic Physicians | |
| N | 208600000X | Surgery | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 500 Martha Jefferson Drive, Administration Mb G254, Charlottesville, VA 229114668 | 4346547794 | 4346547752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306380381 | Martha Jefferson Medical Group LLC | Hospitalist | 500 Martha Jefferson Dr, Mailbox #g236, Charlottesville, VA 22911-4668 | 2016-12-12 |
| Street Address |
590 PETER JEFFERSON PKWY STE 300 |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22911-4628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760840912 | Hearing At Home | Hearing Instrument Specialist | 103 Free Brige Ln, Charlottesville, VA 22911 | 2016-02-03 |
| 1649637752 | Ebony Cosby | Contractor | 2500 Boulders Rd, Charlottesville, VA 22911 | 2016-01-20 |
| 1629452727 | Ahmed M Murtuza | Pharmacist | 925 Dorchester Pl Apt. 103, Charlottesville, VA 22911 | 2015-07-17 |
| 1083093231 | Kimberly P Tran | Dentist | 1470 Pantops Mountain Pl Ste 1, Charlottesville, VA 22911 | 2015-05-20 |
| 1508252982 | Alexandra M Bender | Family Medicine | 3263 Proffit Rd Ste 201, Charlottesville, VA 22911 | 2015-04-13 |
| 1538599980 | Commonwealth Dental Anesthesiology Inc | Clinic/Center | 1460-b Pantops Mountain Place, Charlottesville, VA 22911 | 2013-11-21 |
| 1831386606 | Hudson Chiropractic P.C. | Chiropractor | 103-a Free Bridge Lane, Charlottesville, VA 22911 | 2007-09-26 |
| 1386863421 | Laura P Smith | Specialist | 595 Peter Jefferson Parkway Suite 390, Reproductive Medicine and Surgery Center of Va, Charlottesville, VA 22911 | 2007-04-25 |
| 1609928621 | Bl Enterprises, LLC | Physical Therapist | 1405 Rolkin Court, Suite 102, Charlottesville, VA 22911 | 2007-01-18 |
| 1972660959 | Kenneth I. Barron | Obstetrics & Gynecology | 630 Peter Jefferson Pkwy Ste 140b, Charlottesville, VA 22911 | 2007-01-02 |
| Find all providers in zip 22911 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184199598 | Lietzle Ann Ford | Family Medicine | 2224 Greenbrier Dr, Charlottesville, VA 22901-2919 | 2018-10-11 |
| 1013411842 | Wellfamily Medicine | Family Medicine | 1885 Seminole Trl Ste 105, Charlottesville, VA 22901-1160 | 2018-03-19 |
| 1285152181 | Medexpress Urgent Care, PC - Virginia | Family Medicine | 1563 Broad Crossing Rd, Charlottesville, VA 22911-7480 | 2017-08-31 |
| 1760910202 | Robert Dudley Abbott | Family Medicine | 925 E Jefferson St, Charlottesville, VA 22902-5572 | 2017-05-29 |
| 1467809335 | Kelly Camryn Henkler | Family Medicine | 1800 Timberwood Blvd Ste A, Charlottesville, VA 22911-7544 | 2016-05-19 |
| 1508252982 | Alexandra M Bender | Family Medicine | 3263 Proffit Rd Ste 201, Charlottesville, VA 22911 | 2015-04-13 |
| 1609074319 | Ian Wilson Bushell | Family Medicine | 1000 Research Park Blvd, Suite 200, Charlottesville, VA 22911-5842 | 2007-07-03 |
| 1356557516 | Kaitlyn Anne Beisecker-levin | Family Medicine | 1450 Sachem Pl Unit 201, Charlottesville, VA 22901-2554 | 2007-05-15 |
| 1013060359 | Rivers Edge Family Medicine | Family Medicine | 330 Winding River Lane, Charlottesville, VA 22911-3551 | 2007-01-19 |
| 1730242371 | First Med Inc | Family Medicine | 125 Riverbend Dr Ste 3, Charlottesville, VA 22911-8695 | 2006-12-18 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22911 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.