Healthcare Provider Details

I. General information

NPI: 1508950056
Provider Name (Legal Business Name): VIRGINIA PRIMARY CARE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 COURTHOUSE LANE
BOWLING GREEN VA
22427
US

IV. Provider business mailing address

PO BOX 450
BOWLING GREEN VA
22427
US

V. Phone/Fax

Practice location:
  • Phone: 804-633-5840
  • Fax: 804-633-4438
Mailing address:
  • Phone: 804-633-5840
  • Fax: 804-633-4438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101052515
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101034535
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101237872
License Number StateVA

VIII. Authorized Official

Name: MRS. NIKKI SUANN BROWN
Title or Position: INSURANCE MANAGER
Credential:
Phone: 804-633-5840