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FAMILY MEDICINE OF BLACKSBURG, LLC
NPI 1558550301
Family Medicine in Blacksburg, VA

Active since October 17, 2007CLIA 49D1092643 · Waiver
1645 N MAIN ST, BLACKSBURG, VA 24060(540) 552-1246(540) 552-1247 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Family Medicine Of Blacksburg, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY MEDICINE OF BLACKSBURG, LLC (NPI 1558550301) is a healthcare organization registered as a family medicine in Blacksburg, Virginia and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through September 30, 2027 and lists William Tedrick Johnson, Group Vp/ao, as its authorized official.

NPPES Registry Identity

NPI1558550301
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY MEDICINE OF BLACKSBURG, LLC
Location Address1645 N MAIN STBlacksburg, VA 24060-2554
Mailing Address2000 Health Park DrBrentwood, TN 37027-4525 · (615) 373-7600 · Fax (866) 346-1426
Phone(540) 552-1246
Fax(540) 552-1247
Organization SubpartNo
Authorized OfficialWilliam Tedrick JohnsonGroup Vp/ao · (615) 372-3375
Enumeration DateOctober 17, 2007
Last NPPES UpdateOctober 30, 2020
NPPES CertifiedOctober 30, 2020
✔ NPI 1558550301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1645 N MAIN ST, Blacksburg, VA 24060
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D1092643

Family Medicine Of Blacksburg, LLC · Blacksburg, VA
Active · expires Sep 30, 2027
CLIA Number49D1092643
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2025
Certificate Expiration DateSeptember 30, 2027
Laboratory DirectorScott R. Boerth
Laboratory Phone(540) 552-1246
Laboratory LocationFamily Medicine Of Blacksburg, LLC1645 North Main Street, Blacksburg, VA 24060
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GLENDA BEEKMANN BALL FNP-BC
Nurse Practitioner (Family)
1645 N MAIN ST
BLACKSBURG, VA 24060
Montgomery County (540) 552-1246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Medicine Of Blacksburg, LLC's NPI number?

The NPI number for Family Medicine Of Blacksburg, LLC is 1558550301. It was assigned to this organization in the NPPES registry on October 17, 2007.

Where is Family Medicine Of Blacksburg, LLC located?

Family Medicine Of Blacksburg, LLC is located at 1645 N Main St, Blacksburg, VA 24060. The listed phone number is (540) 552-1246.

What is Family Medicine Of Blacksburg, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Family Medicine Of Blacksburg, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D1092643) is associated with this NPI, valid through September 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Medicine Of Blacksburg, LLC was last updated on October 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.