1013014216 NPI number — LEXINGTON INTERNISTS

Table of content: (NPI 1013014216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013014216 NPI number — LEXINGTON INTERNISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEXINGTON INTERNISTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013014216
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 HOUSTON ST STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24450-2455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-463-2181
Provider Business Mailing Address Fax Number:
540-463-1125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 HOUSTON ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24450-2455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-463-2181
Provider Business Practice Location Address Fax Number:
540-463-1125
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BYERS
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING REPERSENTIVE
Authorized Official Telephone Number:
540-463-2181

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  0101038054 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 0101026313 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 0101054126 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 0101229127 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 0017000116 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 006060722 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 005824931 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060070 . This is a "ANTHEM DR KAREN LYONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 140212 . This is a "ANTHEM DR WILLIAM SAYRE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 144811 . This is a "SOUTHREN HEALTH MALCOLM C" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 110047630 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 110183400 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 144814 . This is a "SOUTHREN HEALTH KAREN LYO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 005853494 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 006071678 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 025665 . This is a "ANTHEM DR KAREN LYONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 060070 . This is a "ANTHEM DR MALCOLM COTHRAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 110047629 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 110215754 . This is a "RAILRAOD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 243608 . This is a "ANTHEM DR LAURA KORNEGAY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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