| Patrick County Family Practice,pc | |
|
18877 Jeb Stuart Highway Stuart VA 24171-1019 | |
| (276) 694-4466 | |
| (276) 694-2909 |
| Full Name | Patrick County Family Practice,pc |
|---|---|
| Speciality | Family Medicine |
| Location | 18877 Jeb Stuart Highway, Stuart, Virginia |
| Authorized Official Name and Position | Richard Claude Cole (PRESIDENT) |
| Authorized Official Contact | 2766944466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick County Family Practice,pc Po Box 1019 Stuart VA 24171-1019 Ph: (276) 694-4466 | Patrick County Family Practice,pc 18877 Jeb Stuart Highway Stuart VA 24171-1019 Ph: (276) 694-4466 |
| NPI Number | 1053322495 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 04/16/2008 |
| Medicare PECOS PAC ID | 0941232557 |
|---|---|
| Medicare Enrollment ID | O20050906000640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053322495 | NPI | - | NPPES |
| 0232E | Other | NC | BLUE CROSS BLUE SHIELD |
| 006211313 | Medicaid | VA | |
| 097029 | Other | VA | ANTHEM BCBS GROUP # |
| 7902459 | Medicaid | NC | |
| 010181861 | Medicaid | VA | |
| 005657342 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101 036915 (Virginia) | Primary |
| 207R00000X | Internal Medicine | 0101 237621 (Virginia) | Secondary |
| Provider Name | Ralph L Kramer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235136920 PECOS PAC ID: 3779517883 Enrollment ID: I20080605000747 |
| Provider Name | Richard C Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972500668 PECOS PAC ID: 5698709707 Enrollment ID: I20080605000784 |
| Provider Name | Elizabeth Anne Shockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861499691 PECOS PAC ID: 0143355404 Enrollment ID: I20101102001445 |
| Provider Name | Pamela Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164739751 PECOS PAC ID: 8123267838 Enrollment ID: I20130610000337 |
| Provider Name | Timothy Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689661761 PECOS PAC ID: 3678505591 Enrollment ID: I20130617000329 |
| Provider Name | Dana S Mabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386873198 PECOS PAC ID: 8022162692 Enrollment ID: I20130812000527 |
| Provider Name | Kaitlyn Grace Cobler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073093027 PECOS PAC ID: 5991048183 Enrollment ID: I20190509001133 |
| Provider Name | Meagan Nichole Radford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003433590 PECOS PAC ID: 1759798358 Enrollment ID: I20210326001404 |
| Provider Name | Timonthy Donell Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992396022 PECOS PAC ID: 8426466285 Enrollment ID: I20210415000191 |
| Provider Name | Brittney Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881063600 PECOS PAC ID: 6103127964 Enrollment ID: I20210527002027 |
Patrick County Family Practice Pc Rhc Stuart Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18877 Jeb Stuart Highway, Stuart, VA 24171 Phone: 276-694-4466 Fax: 276-694-2909 | |
Patrick Hospital Express Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18688 Jeb Stuart Hwy, Stuart, VA 24171 Phone: 276-694-8678 Fax: 276-694-8655 | |
Pioneer Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 835 Woodland Dr, Stuart, VA 24171 Phone: 276-694-6677 Fax: 276-694-6827 | |
Patrick Hospital, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18688 Jeb Stuart Hwy, Stuart, VA 24171 Phone: 276-694-8678 Fax: 276-694-8655 | |
Pch Express Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18688 Jeb Stuart Hwy, Stuart, VA 24171 Phone: 276-694-3151 Fax: 276-694-8655 | |
Tri Area Community Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18877 Jeb Stuart Hwy, Stuart, VA 24171 Phone: 276-694-4466 Fax: 276-694-2909 |