OrganizationActive
Fancy Gap Internal Medicine
NPI 1376940643 · Internal Medicine Physician · Fancy Gap, VA
Provider details
- NPI number
- 1376940643
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Susan Roberts, Nurse Practitioner(336) 707-7734
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Phone: (276) 728-0735
Fax: (276) 728-7717
Street-level locationGet directions
Mailing address
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Registry dates
- Enumerated
- 2014-12-02
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.