NPIMap

Organization Active NPI

Eastern Shore Rural Health System Incorporated

Doing business as Metompkin Elementary School Dental Program

  • Federally Qualified Health Center (FQHC)
  • Parksley, VA
National Provider Identifier
1043463227
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED
Doing business as
Metompkin Elementary School Dental Program
Practice address
24501 Parksley Rd
Parksley, VA 23421-2519
Phone
(757) 665-1159
Fax
(757) 665-1846
NPI assigned
Oct 31, 2008
Last updated
Mar 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Jeannette Edwards
Title
Chief Executive Officer
Phone
(757) 414-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

24501 Parksley Rd
Parksley, VA 23421-2519

Mailing address

20280 Market St
Onancock, VA 23417-1331
Phone (757) 414-0431

Other names 1

  • Metompkin Elementary School Dental Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastern Shore Rural Health System Incorporated10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1043463227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 MARKET ST",
            "city": "ONANCOCK",
            "state": "VA",
            "postal_code": "234171331",
            "telephone_number": "757-414-0431",
            "fax_number": "757-414-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24501 PARKSLEY RD",
            "city": "PARKSLEY",
            "state": "VA",
            "postal_code": "234212519",
            "telephone_number": "757-665-1159",
            "fax_number": "757-665-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE RURAL HEALTH SYSTEM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "757-414-0400"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metompkin Elementary School Dental Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metompkin Elementary School Dental Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parksley, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.