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PROVIDENCE MEDICAL LLC
NPI 1831056191
Nurse Practitioner - Family in Fredericksburg, VA

Active since January 08, 2026
150 RIVERSIDE PKWY STE 115 PMB 5560, FREDERICKSBURG, VA 22406(347) 571-1312 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 14, 2026, Jan 8, 2026 (2 updates tracked since 2026).

About Providence Medical Llc NPPES

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

PROVIDENCE MEDICAL LLC (NPI 1831056191) is a healthcare organization registered as a family in Fredericksburg, Virginia and active in the NPI registry since January 2026. The organization lists Matthew Daugherty, Ceo, as its authorized official.

NPPES Registry Identity

NPI1831056191
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePROVIDENCE MEDICAL LLC
Location Address150 RIVERSIDE PKWY STE 115 PMB 5560Fredericksburg, VA 22406-1094
Mailing Address150 Riverside Pkwy Ste 115Fredericksburg, VA 22406-1094 · (347) 571-1312
Phone(347) 571-1312
Organization SubpartNo
Authorized OfficialMatthew DaughertyCeo · (347) 571-1312
Enumeration DateJanuary 8, 2026
Last NPPES UpdateJanuary 14, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2026
✔ NPI 1831056191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
150 RIVERSIDE PKWY STE 115 PMB 5560, Fredericksburg, VA 22406
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Providence Medical LLC's NPI number?

The NPI number for Providence Medical LLC is 1831056191. It was assigned to this organization in the NPPES registry on January 8, 2026.

Where is Providence Medical LLC located?

Providence Medical LLC is located at 150 Riverside Pkwy Ste 115 Pmb 5560, Fredericksburg, VA 22406. The listed phone number is (347) 571-1312.

What is Providence Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Providence Medical LLC was last updated on January 14, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.