DOMINION HEALTH MEDICAL ASSOC (NPI# 1669572897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669572897 |
| Entity Type | Organization |
| Organization Name | DOMINION HEALTH MEDICAL ASSOC |
| Other Organization Name | SENTARA CLARKSVILLE FAMILY MEDICINE |
| Practice Address |
115 College St Clarksville VA 23927 |
| Mailing Address |
P.o. Box 860 South Boston VA 24592 |
| Practice Telephone | 4343745344 |
| Practice Fax Number | 4345173887 |
| Mailing Telephone | 4345173513 |
| Mailing Fax Number | 4345173887 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-02-11 |
| Authorized Official Name | CECIL HAZELWOOD (MANAGER (SDHG)) |
| Authorized Official Telephone | 4345173515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 0101032102 | VA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Sentara Clarksville Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1689772238 | Dominion Health Medical Assoc | Legal Medicine | 946 N. Main St, Chase City, VA 23924 | 2006-09-20 |
| 1568933182 | Dominion Health Medical Assoc | Clinic/Center | 101 Aubreys Loop, South Boston, VA 24592-5054 | 2018-12-07 |
| 1457756322 | Dominion Health Medical Assoc | Pediatrics | 101 Aubreys Loop, South Boston, VA 24592-5054 | 2014-11-04 |
| 1427306315 | Dominion Health Medical Assoc | Specialist | 2232 Wilborn Ave, Suite F, South Boston, VA 24592 | 2012-08-27 |
| 1760740625 | Dominion Health Medical Assoc | Clinic/Center | 2206 Wilborn Ave, South Boston, VA 24592 | 2012-04-30 |
| 1134407570 | Dominion Health Medical Assoc | Clinic/Center | 2204 Wilborn Ave, South Boston, VA 24592 | 2011-08-03 |
| 1639457179 | Dominion Health Medical Assoc | Anesthesiology | 2204 Wilborn Ave, South Boston, VA 24592 | 2011-08-02 |
| 1598928277 | Dominion Health Medical Assoc | Legal Medicine | 2232 Wilborn Ave, Suite C, South Boston, VA 24592 | 2008-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DOMINION HEALTH MEDICAL ASSOCIATES LTD. | 2204 Wilborn Ave, South Boston, Virginia 24592 |
| Street Address |
115 COLLEGE ST |
| City | CLARKSVILLE |
| State | VA |
| Zip Code | 23927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154930824 | Halifax Regional Hospital, Inc | Clinic/Center | 115 College St, Clarksville, VA 23927-9125 | 2020-07-28 |
| 1861755746 | Rachael Burton | Family Medicine | 115 College St, Clarksville, VA 23927 | 2012-06-16 |
| 1902103096 | Jessica Ruff | Nurse Practitioner | 115 College St, Clarksville, VA 23927-9125 | 2011-02-25 |
| 1568650802 | Vivia Brogden Whitfield | Nurse Practitioner | 115 College St, Clarksville, VA 23927-9125 | 2007-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912252958 | Southside Csb | Intermediate Care Facility, Mentally Retarded | 143 Industrial Pky, Clarksville, VA 23927 | 2012-07-16 |
| 1730485905 | Southside Csb | Intermediate Care Facility, Mentally Retarded | 143 Industrial Pkwy, Clarksville, VA 23927 | 2011-02-04 |
| 1346306859 | Reginald S Young | Dentist | 611 Virginia Avenue, Clarksville, VA 23927 | 2006-12-29 |
| 1083792261 | Clarksville Counseling Center, Plc | Counselor | 403 Virginia Avenue, Suite F, Clarksville, VA 23927 | 2006-11-02 |
| 1396830956 | Sabrina Bullock | Midwife | 606 Virginia Avenue, Clarksville, VA 23927 | 2006-10-03 |
| 1831282946 | Food Lion LLC | Durable Medical Equipment & Medical Supplies | 1013 Virginia Ave, Clarksville, VA 23927 | 2006-10-02 |
| 1255350807 | Clarksville Community Pharmacy, Inc. | Pharmacist | 11226 Hwy. 15 S., Clarksville, VA 23927 | 2006-07-18 |
| 1619974029 | Clarksville Senior Care, LLC | Skilled Nursing Facility | 184 Buffalo Rd, Clarksville, VA 23927 | 2005-06-30 |
| 1518915651 | Clarksville Senior Care, LLC | Durable Medical Equipment & Medical Supplies | 184 Buffalo Rd, Clarksville, VA 23927 | 2006-05-04 |
| 1124271358 | Richard L Brown | Chiropractor | 914-c Virginia Ave, Clarksville, VA 23927-0933 | 2008-10-31 |
| Find all providers in zip 23927 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295721702 | Rayford Lee Tackett | Legal Medicine | 23 Professional Park Dr, Clarksville, AR 72830-4432 | 2005-09-21 |
| 1518957240 | Family Practice Associates of Clarksville,pa | Legal Medicine | 23 Professional Park Dr, Clarksville, AR 72830-4432 | 2005-10-25 |
| 1104812619 | John Robert Mcauley | Legal Medicine | 23 Professional Park Dr, Clarksville, AR 72830-4432 | 2005-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740628007 | Surgical Care of The Virginias, LLC | Legal Medicine | Unit 101 Westwood Commons, Westwood Medical Park, Bluefield, VA 24605-0237 | 2013-06-10 |
| 1194068577 | Kraidy & Alkaffaf, LLC | Legal Medicine | 9025 Kiger Street, Lorton, VA 22079 | 2013-04-03 |
| 1366770547 | Philip R Thomas Md., Ltd | Legal Medicine | 112 Kings Hwy, Suffolk, VA 23432-1117 | 2009-11-25 |
| 1568622868 | Tristate Rural Health Clinic | Legal Medicine | 20757 Riverside Dr, Grundy, VA 24614-6746 | 2008-06-11 |
| 1871784496 | Urgent Care Hayfield | Legal Medicine | 7598 Telegraph Rd, Alexandria, VA 22315-3829 | 2007-08-08 |
| 1629269139 | L. Glenn Christie Md Ltd | Legal Medicine | 7605 Forest Ave Ste 402, Richmond, VA 23229-4939 | 2007-08-08 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1922135193 | Emergicare of Harrisonburg, Inc. | Legal Medicine | 755a Cantrell Ave, Harrisonburg, VA 22801-4366 | 2007-02-27 |
| 1114091931 | Union Mill Pediatrics,pc | Legal Medicine | 13880 Braddock Rd. Ste 201, Centreville, VA 20121 | 2006-11-20 |
| 1578637997 | Lawrence Amos | Legal Medicine | 103 Free Bridge Ln, Charlottesville, VA 22911-8446 | 2006-11-17 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSVILLE |
| Zip Code | 23927 |
Please comment or provide details below to improve the information on DOMINION HEALTH MEDICAL ASSOC.
| 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.