WYTHE COUNTY PHYSICIAN PRACTICES LLC – Family Medicine Physician, NPI 1780630327
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for WYTHE COUNTY PHYSICIAN PRACTICES LLC
360 Virginia Ave Ste B
Wytheville, VA 243821185
Phone: (276) 228-0080
Type: Location
330 SEVEN SPRINGS WAY
BRENTWOOD, TN 370275098
Phone: (615) 920-7000
Fax: (615) 920-8775
Type: Mailing
Wythe County Community Hospital, 600, West Ridge Road, Wytheville, Wythe County, Virginia, 24382, United States
WYTHEVILLE, VA 243821044
Phone: (276) 228-0200
Fax: (276) 228-0397
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20060209000451 | O | Clinic/Group Practice | VA | TBD |
| O20250108001693 | O | Clinic/Group Practice | FL | TBD |
| O20250109000201 | O | Clinic/Group Practice | PA | TBD |
| O20250227001360 | O | Clinic/Group Practice | SC | TBD |
| O20250227002326 | O | Clinic/Group Practice | MI | TBD |
| O20250509002912 | O | Clinic/Group Practice | LA | TBD |
| O20251219002444 | O | Clinic/Group Practice | NV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 24382)
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