Healthcare Provider Details

I. General information

NPI: 1427016419
Provider Name (Legal Business Name): RAPIDAN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 GERMANNA HWY SUITE 310
LOCUST GROVE VA
22508-2035
US

IV. Provider business mailing address

4444 GERMANNA HWY SUITE 310
LOCUST GROVE VA
22508-2035
US

V. Phone/Fax

Practice location:
  • Phone: 540-972-6222
  • Fax:
Mailing address:
  • Phone: 540-972-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number0101058684
License Number StateVA

VIII. Authorized Official

Name: DR. KENNETH SCOTT JOHNSON
Title or Position: PRESIDENT, MEDICAL DIRECTOR
Credential: M.D.
Phone: 540-972-6222