MEDICARE: MARTINSVILLE PRIMARY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1497648661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTINSVILLE PRIMARY CARE LLC

Provider Business Mailing Address
First Line	:	106 SALMON ST
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-3211
Country	:	US
Telephone Number	:	276-634-0010
Fax Number	:	276-632-0120

Provider Business Practice Location Address
First Line	:	106 SALMON ST
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-3211
Country	:	US
Telephone Number	:	276-634-0010
Fax Number	:	276-632-0120

Authorized Official
Title or Position	:	OWNER
Name	:	AMBER PATTERSON
Credential	:	FNP-C
Telephone Number	:	276-634-0010

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	04/16/2026

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