|
| |
|
25 Northridge Ln Lexington VA 24450-3399 | |
| (540) 464-8700 | |
| (540) 464-1323 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 Northridge Ln, Lexington, Virginia |
| Authorized Official Name and Position | Valerie Suzanne Sheridan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5404648700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
25 Northridge Ln Lexington VA 24450-3399 Ph: (540) 464-8700 | 25 Northridge Ln Lexington VA 24450-3399 Ph: (540) 464-8700 |
| NPI Number | 1205267002 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 2860626231 |
|---|---|
| Medicare Enrollment ID | O20131018000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205267002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Roger Lee Clevinger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891760096 PECOS PAC ID: 7618864968 Enrollment ID: I20040302000143 |
| Provider Name | Laura Judith Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134597719 PECOS PAC ID: 0143539510 Enrollment ID: I20151026001992 |
| Provider Name | Kimary Schatten |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538430558 PECOS PAC ID: 4981992682 Enrollment ID: I20161012002748 |
| Provider Name | Denise A Oinonen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528620374 PECOS PAC ID: 9436480399 Enrollment ID: I20191008002749 |
| Provider Name | Mariah Lynn Mcmillan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386218774 PECOS PAC ID: 0941601090 Enrollment ID: I20210625002129 |
| Provider Name | Michael David Henry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083766299 PECOS PAC ID: 5597161018 Enrollment ID: I20210909000722 |
| Provider Name | Kelsey Griffith Brown |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922693316 PECOS PAC ID: 7416354097 Enrollment ID: I20210923003601 |
| Provider Name | Raeanna Poplus Simcoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174917082 PECOS PAC ID: 6608111315 Enrollment ID: I20220525002057 |
| Provider Name | Linh Tran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134787211 PECOS PAC ID: 7618350646 Enrollment ID: I20220823004081 |
| Provider Name | Scott Edward Kleinert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326694332 PECOS PAC ID: 6002268265 Enrollment ID: I20240123004632 |
| Provider Name | Abigail Lee Sorrells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558048678 PECOS PAC ID: 1951846781 Enrollment ID: I20240716003451 |
| Provider Name | Katherine Matthews Squires |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669108379 PECOS PAC ID: 0840735601 Enrollment ID: I20240716004461 |
| Provider Name | Amanda Hartless Mccomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467298208 PECOS PAC ID: 3577552181 Enrollment ID: I20240904004840 |
| Provider Name | Mary Tere Zamora Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740542935 PECOS PAC ID: 3870867682 Enrollment ID: I20241101002084 |
Carilion Rockbridge Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Health Cir, Lexington, VA 24450 Phone: 540-458-3300 | |
Carilion Rockbridge Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Health Cir, Lexington, VA 24450 Phone: 540-224-5125 Fax: 540-985-4948 | |
Rockbridge Area Free Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 170 Kendal Dr Ste A, Lexington, VA 24450 Phone: 540-464-8700 Fax: 855-806-0826 | |
Augusta Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 55 Comfort Way Ste 1, Lexington, VA 24450 Phone: 540-463-3381 | |
Patient Choice Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 Comfort Way, Suite 1, Lexington, VA 24450 Phone: 540-463-3381 Fax: 540-463-3477 | |