PERFORMANCE MEDICINE OF SOUTHWEST VIRGINIA LLC (NPI# 1679905467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679905467 |
| Entity Type | Organization |
| Organization Name | PERFORMANCE MEDICINE OF SOUTHWEST VIRGINIA LLC |
| Practice Address |
25 W Calhoun St Salem VA 24153-3836 |
| Mailing Address |
Po Box 8310 Roanoke VA 24014-0310 |
| Practice Telephone | 5407721890 |
| Practice Fax Number | 5407721893 |
| Mailing Telephone | 5403453556 |
| Mailing Fax Number | 5403422193 |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | DELMAS J BOLIN (MEMBER) |
| Authorized Official Telephone | 5403453556 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
25 W CALHOUN ST |
| City | SALEM |
| State | VA |
| Zip Code | 24153-3836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548237993 | Delmas J Bolin | Family Medicine | 25 W Calhoun St, Salem, VA 24153-3836 | 2006-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710373444 | Larry Bassinger | Family Medicine | 1300 Broadway St Ne Ste 104, Salem, OR 97301-1420 | 2015-04-09 |
| 1396144507 | Constance Johanson | Family Medicine | 3959 Croisan Creek Rd S, Salem, OR 97302-9474 | 2014-08-14 |
| 1457792699 | Sultan Seretis Bussey Hospitalist LLC | Family Medicine | 310 Route 45, Salem, NJ 08079-2064 | 2013-07-16 |
| 1629338470 | Derek Koller | Family Medicine | 6861 Lemongrass Loop Se, Salem, OR 97306-1474 | 2012-05-25 |
| 1962712927 | Paul Julian Perrin | Family Medicine | 525 Ferry St Se, Suite 203, Salem, OR 97301 | 2010-10-08 |
| 1326372558 | Robert Verne Bain | Family Medicine | 2280 Kuebler Road, South, Salem, OR 97302 | 2009-09-21 |
| 1902036320 | James A. Auerbach, M.d., P.C. | Family Medicine | 4747 Skyline Rd S, Suite 190, Salem, OR 97306-4200 | 2009-07-20 |
| 1033347430 | Jeanette Walker | Family Medicine | 5560 Witzel Rd Se, Salem, OR 97317-9142 | 2009-06-24 |
| 1871747188 | Carmelle Marie Andrine Constant | Family Medicine | 84 Highland Ave Ste 309, Salem, MA 01970-2733 | 2008-11-13 |
| 1518127927 | Mazen I Madhoun | Family Medicine | 3737 W Main St Ste 101, Salem, VA 24153-2073 | 2008-06-10 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.