BECKFORD AVENUE MEDICAL CENTER INC NPI 1972606820

Family Medicine in Warrenton, NC

NPI 1972606820 Organization Family Medicine CLIA Number 34D2015099 CLIA Certificate of Waiver

About BECKFORD AVENUE MEDICAL CENTER INC

Beckford Avenue Medical Center Inc is a primary care provider established in Warrenton, North Carolina specializing in family medicine. The NPI number of Beckford Avenue Medical Center Inc is 1972606820 and was assigned on September 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 23579 (NC). The provider is registered as an organization and their NPI record was last updated 12 years ago. Beckford Avenue Medical Center Inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is James E Kenney M.d. (President)

A primary care provider (PCP) like Beckford Avenue Medical Center Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Beckford Avenue Medical Center Inc is 34D2015099 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Beckford Avenue Medical Center Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1972606820

Provider NameBECKFORD AVENUE MEDICAL CENTER INC
Provider Location Address816 US HWY 158 W SUITE 102 WARRENTON, NC 27589
Provider Mailing Address816 US HWY 158 W SUITE 102 WARRENTON, NC 27589
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-06-2006
Last Update Date04-14-2010


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.23579
License StateNC
Taxonomy DescriptionFamily 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.

Business Address

BECKFORD AVENUE MEDICAL CENTER INC
816 US HWY 158 W SUITE 102
WARRENTON, NC
ZIP 27589
Phone: (252) 257-6213
Fax: (252) 257-3286

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Mailing Address

BECKFORD AVENUE MEDICAL CENTER INC
816 US HWY 158 W SUITE 102
WARRENTON, NC
ZIP 27589
Phone: (252) 257-6213
Fax: (252) 257-3286



Authorized Official

Authorized Official Name JAMES E KENNEY M.D.
Authorized Official TitlePRESIDENT
Authorized Official Phone(252) 257-6213

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1972606820 is:

CLIA Number34D2015099
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


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

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
89015AYMEDICAID (05)NC
C84896MEDICARE UPIN (02)NC
2336015MEDICARE PIN (08)NC

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.