1447298880 NPI number — DR. BETHANNE HILL ELBERT MD

Table of content: DR. BETHANNE HILL ELBERT MD (NPI 1447298880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447298880 NPI number — DR. BETHANNE HILL ELBERT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELBERT
Provider First Name:
BETHANNE
Provider Middle Name:
HILL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILL
Provider Other First Name:
BETHANNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447298880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4444 GERMANNA HWY
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
LOCUST GROVE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22508-2035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-972-6222
Provider Business Mailing Address Fax Number:
540-972-6299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4444 GERMANNA HWY
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
LOCUST GROVE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22508-2035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-972-6222
Provider Business Practice Location Address Fax Number:
540-972-6299
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0101057113 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 005829496 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45801 . This is a "COMMUNITY HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 45801 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 700010127 . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 119076 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 268470 . This is a "MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 119076 . This is a "ANTHEM SVCS/HEALTHKEEPERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 146234 . This is a "SOUTHERN HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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