Active NPI
Nathan Ian Dalleave
- Skilled Nursing Facility
- Martinsville, VA
National Provider Identifier
1033660360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 03479
- Practice address
- 1243 Lanier Rd
Martinsville, VA 24112-5211 - Phone
- (336) 437-5392
- NPI assigned
- Oct 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 03479 | NC | Primary |
Addresses
Primary practice location
1243 Lanier Rd
Martinsville, VA 24112-5211
Mailing address
1243 Lanier Rd
Martinsville, VA 24112-5211
Phone (336) 437-5392
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03479 | NC | MD | Skilled Nursing Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477008000000",
"number": "1033660360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1243 LANIER RD",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241125211",
"telephone_number": "336-437-5392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1243 LANIER RD",
"city": "MARTINSVILLE",
"state": "VA",
"postal_code": "241125211",
"telephone_number": "336-437-5392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLEAVE",
"first_name": "NATHAN",
"middle_name": "IAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-21",
"last_updated": "2016-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "03479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.