1053498071 NPI number — LYNCHBURG NEPHROLOGY PHYSICIANS PLLC

Table of content: NATALIE LAUREN WILVER PHD (NPI 1669141594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053498071 NPI number — LYNCHBURG NEPHROLOGY PHYSICIANS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LYNCHBURG NEPHROLOGY PHYSICIANS PLLC
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:
6
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:
1053498071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2091 LANGHORNE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNCHBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24501-1428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-947-3954
Provider Business Mailing Address Fax Number:
833-973-4003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2091 LANGHORNE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24501-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-947-3954
Provider Business Practice Location Address Fax Number:
434-947-5944
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RUNIONS
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
805-345-5956

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 30015178890001 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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