| Appomattox River Primary Care, Llc | |
|
815 W Poythress St Hopewell VA 23860-2532 | |
| (804) 458-8557 | |
| (804) 541-7113 |
| Full Name | Appomattox River Primary Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 815 W Poythress St, Hopewell, Virginia |
| Authorized Official Name and Position | Suzanne Bergamo (DIVISION VP/AO) |
| Authorized Official Contact | 8042675950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Appomattox River Primary Care, Llc Po Box 748482 Atlanta GA 30374-8482 Ph: (615) 373-7600 | Appomattox River Primary Care, Llc 815 W Poythress St Hopewell VA 23860-2532 Ph: (804) 458-8557 |
| NPI Number | 1023764982 |
|---|---|
| Provider Enumeration Date | 03/01/2022 |
| Last Update Date | 03/01/2022 |
| Medicare PECOS PAC ID | 8022493469 |
|---|---|
| Medicare Enrollment ID | O20220921000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023764982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James A Bush |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942273909 PECOS PAC ID: 7012905763 Enrollment ID: I20040503001062 |
| Provider Name | George W Proffitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306819628 PECOS PAC ID: 2466471883 Enrollment ID: I20051115000834 |
| Provider Name | Brent A Armstrong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306959895 PECOS PAC ID: 8921183823 Enrollment ID: I20080317000119 |
| Provider Name | Frank C Jordaens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972599447 PECOS PAC ID: 8527147628 Enrollment ID: I20080430000850 |
| Provider Name | Stacy R Ingram-hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699748905 PECOS PAC ID: 9335228436 Enrollment ID: I20080430000857 |
| Provider Name | Albert Magnin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760454276 PECOS PAC ID: 1355420449 Enrollment ID: I20080501000054 |
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