IVY FAMILY MEDICINE PLC NPI 1073818787

NPI Information

NPI: 1073818787
Provider Name: IVY FAMILY MEDICINE, PLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 49D2022977

Address:
2 BOARS HEAD PL
SUITE 110
CHARLOTTESVILLE, VA
ZIP 22903
Phone: (434) 466-8363
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IVY FAMILY MEDICINE, PLC is a primary care clinic center in Charlottesville, VA. IVY FAMILY MEDICINE, PLC NPI is 1073818787. The provider is registered as an organization entity type.

The provider's business location address is:

2 BOARS HEAD PL
SUITE 110
CHARLOTTESVILLE, VA
ZIP 22903-611
Phone: (434) 466-8363

The provider's authorized official is Lily Wise Hargrove .
The authorized official title is Owner and has the following contact phone number (434) 466-8363.

The CLIA number assigned to this NPI record is 49D2022977 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/12/2011 and was last updated on 4/18/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	0101057199	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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