Pamunkey Indian Tribe

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PAMUNKEY INDIAN TRIBE

Practice address

1054 Pocahontas TRL
King William, VA 23086-2114

Phone

(804) 885-3338

NPI assigned

Jun 20, 2025

Last updated

Jun 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Matens

Title

Executive Director

Phone

(804) 885-3344

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1053208140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 POCAHONTAS TRL",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230862114",
            "telephone_number": "804-885-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 POCAHONTAS TRL",
            "city": "KING WILLIAM",
            "state": "VA",
            "postal_code": "230862114",
            "telephone_number": "804-885-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMUNKEY INDIAN TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "MATENS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-885-3344"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• King William County Public Schools
• Isabelle Kress, M.S., CCC-SLP
• Caitlin Elizabeth Lange
• Timothy Wayne McDaniel, P.T.
• Philip Mitchell, L.P.C.
• Wendy G Phillips, L.C.S.W.
• Morgan Plowman, COTA/L
• Tiffany E Polo
• Robert M Rose, M.D.
• Kristen Russell

• Health Service Clinic/Center in King William, VA
• Providers in King William, VA by specialty
• Health Service Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.