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Contact Information

COMMONWEALTH PRIMARY CARE
4050 INNSLAKE DR
STE 308
GLEN ALLEN, VA23060
 Phone: 804-521-5310
 Fax: 804-521-5312
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COMMONWEALTH PRIMARY CARE

NPI Number 1336157858
LBN Legal business name COMMONWEALTH PRIMARY CARE
Authorized official KELLY SHEPHERD - (HOSPITALIST ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/03/2006
Last updated 11/08/2007 - About 19 years ago
Identifiers
VA Other 139440 ANTHEM BCBS
VA Other 139444 ANTHEM BCBS
VA Other CC6597 MEDICARE RR
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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