STONEWALL PEDIATRICS NPI 1093922726

NPI Information

  • NPI: 1093922726
  • Provider Name: STONEWALL PEDIATRICS
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 108 HOUSTON ST
    SUITE E
    LEXINGTON, VA
    ZIP 24450
  • Phone: (540) 463-3162

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NPI Details

STONEWALL PEDIATRICS is a specialist in Lexington, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. STONEWALL PEDIATRICS NPI is 1093922726. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

108 HOUSTON ST
SUITE E
LEXINGTON, VA
ZIP 24450-455
Phone: (540) 463-3162
Fax: (540) 463-3213

The provider's authorized official is William M Jacobs .
The authorized official title is Pediatrician - President and has the following contact phone number (540) 463-3162.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 8/22/2020.

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
1174400000XSpecialist0101030878VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11487706693OTHERVIRGINIANPI FOR PHYSICIAN ASST.
26737846MEDICAIDVIRGINIA
31962587287OTHERVIRGINIANPI

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: 11/21/2025

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