1174505945 NPI number — KIM H COMBS MD

Table of content: KIM H COMBS MD (NPI 1174505945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174505945 NPI number — KIM H COMBS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COMBS
Provider First Name:
KIM
Provider Middle Name:
H
Provider Name Prefix Text:
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:
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:
1174505945
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2019 TATE SPRINGS 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:
24501-1111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-846-7374
Provider Business Mailing Address Fax Number:
434-846-1910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2019 TATE SPRINGS 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:
24501-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-846-7374
Provider Business Practice Location Address Fax Number:
434-846-1910
Provider Enumeration Date:
11/17/2005

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: 207Q00000X , with the licence number:  0101056205 , 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: 7469527 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 005640032 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CF1947 . This is a "MEDICARE RAILROAD GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0101872 . This is a "UNITED HEALTHCARE GROUPS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 226882 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080143060 . This is a "MEDICARE RAILROAD PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1184797789 . This is a "CVFP SITE NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1528155892 . This is a "CVFP CORPORATE NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 170847 . This is a "SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: C03658 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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