Moniesha Avita Javon Bullock

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

508 Little Margaret LN
Henrico, VA 23075-1647

Phone

(804) 822-8661

NPI assigned

Sep 9, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Mothers Care

  • Rehabilitation Practitioner
  • Highland Springs, VA
  • NPI 1225644925
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1003465402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 LITTLE MARGARET LN",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "230751647",
            "telephone_number": "804-822-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 LITTLE MARGARET LN",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "230751647",
            "telephone_number": "804-822-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MONIESHA",
        "middle_name": "AVITA JAVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "1amotherscare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "508 Little Margaret Ln",
            "city": "Henrico",
            "state": "VA",
            "country_code": "US",
            "postal_code": "230751647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "1amothercare@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "508 Little Margaret Ln",
            "city": "Henrico",
            "state": "VA",
            "country_code": "US",
            "postal_code": "230751647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Buchanan, RPH
• Richard M Buck Jr., PT
• Scott Buff
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• Building Individuals Gradually Counseling Services B.I.G LLC
• Zachary Danial Burden, FNP
• Chamique Burgess
• Linda Burkett, M.D.
• Robin Burns, LPN
• Alexandra Jane Burrows, LCSW

• All providers in Henrico, VA
• In Home Supportive Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.