SOUTH RIVER MEDICAL CLINIC, LLC (NPI# 1922381789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922381789 |
| Entity Type | Organization |
| Organization Name | SOUTH RIVER MEDICAL CLINIC, LLC |
| Practice Address |
100 7th Street Grottoes VA 24441 |
| Mailing Address |
Po Box 489 Grottoes VA 24441-0489 |
| Practice Telephone | 5402495901 |
| Practice Fax Number | 5402495902 |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2012-08-03 |
| Authorized Official Name | ANNA WILLIAMS (OFFICE MANAGER) |
| Authorized Official Telephone | 5402495901 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
100 7TH STREET |
| City | GROTTOES |
| State | VA |
| Zip Code | 24441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912908468 | Mary C Koogler | Nurse Practitioner | 100 7th Street, Grottoes, VA 24441-0489 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093234247 | Lou J. Dellinger | Speech-Language Pathologist | 2101 Elm Ave., South River Elem. School, Grottoes, VA 24441 | 2017-09-19 |
| 1821171950 | Valley Pharmacies Inc | Pharmacy | 402 Augusta Avenue, Grottoes, VA 24441 | 2006-10-23 |
| 1942217799 | Nancy Wise Jordan | Dentist | 108 6th St, Grottoes, VA 24441 | 2006-08-02 |
| 1366512204 | Daniel Roger Atwell | Pharmacist | 1003 Dogwood Avenue, Grottoes, VA 24441-0338 | 2006-11-08 |
| 1164401295 | Sheri A Tratnack | Registered Nurse | 100 7th St, Grottoes, VA 24441-1708 | 2006-01-17 |
| 1205206091 | Brandon Miles Cunningham | Nurse Practitioner | 100 7th St, Grottoes, VA 24441-1708 | 2015-10-06 |
| 1285717322 | Valley Pharmacies Inc | Pharmacy | 1003 Dogwood Ave, Grottoes, VA 24441-1946 | 2006-10-23 |
| 1891894507 | Angela K Brittle | Pharmacist | 1003 Dogwood Avenue, Grottoes, VA 24441-2405 | 2006-09-21 |
| 1740529262 | Janice Bence | Occupational Therapist | 1508 Battlefield Rd, Grottoes, VA 24441-4300 | 2013-02-04 |
| 1386843274 | Roger Lee Mace | Counselor | 13491 Port Republic Rd, Grottoes, VA 24441-5216 | 2007-07-12 |
| Find all providers in zip 24441 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626478 | Partners In Family Practice LLC | Clinic/Center | 430 Clairmont Ct Ste 123, Colonial Heights, VA 23834-1770 | 2020-10-09 |
| 1730790874 | Janice G. Sadaya-conda M.d., Pllc | Clinic/Center | 6128 Brandon Ave Ste 225, Springfield, VA 22150-2640 | 2020-08-12 |
| 1598375610 | Johnson Venture Management Solutions, Inc. | Clinic/Center | 17 Langley Blvd Bldg 1216, Hampton, VA 23681-2143 | 2020-08-04 |
| 1376161745 | Susan Minter Dnp Aprn LLC | Clinic/Center | 1234 Ridout Rd, La Crosse, VA 23950-2808 | 2020-07-11 |
| 1295359883 | Advanced Onsite Care LLC | Clinic/Center | 1045 Robert Welch Ln, Chesapeake, VA 23320-6770 | 2020-05-30 |
| 1962022392 | Gladeview Medical LLC | Clinic/Center | 279 Gladeview Dr, Fries, VA 24330-3936 | 2020-04-27 |
| 1578182986 | Libertas Leadership | Clinic/Center | 405 Sperryville Pike, Culpeper, VA 22701-2151 | 2020-04-15 |
| 1497395768 | Holistic Health and Healing Inc | Clinic/Center | 3690 Greensboro Road, Ridgeway, VA 24148 | 2020-01-14 |
| 1700426244 | Quad/med, LLC | Clinic/Center | 366 Draft Avenue, Stuarts Draft, VA 24477-2941 | 2020-01-13 |
| 1114560653 | Amy Beyer LLC | Clinic/Center | 2611 Thomas Jefferson Pkwy, Palmyra, VA 22963-5000 | 2019-10-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTH RIVER MEDICAL CLINIC, LLC.
| 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.