Commonwealth of Virginia State Board of Health

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

Practice address

26022 Administrative Center Drive
Courtland, VA 23837-0009

Phone

(757) 653-3040

Fax

(757) 653-0834

NPI assigned

Feb 22, 2006

Organization subpart

No

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

Authorized official

Name

Angela Yvette Tillery

Title

Business Manager

Phone

(757) 514-4765

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Southampton County Health Department Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Mae Welch, M.D, M.H.A., M.B.A.

  • Public Health & General Preventive Medicine Physician
  • Chesapeake, VA
  • NPI 1982665188
  NPD

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1053386979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26022 ADMINISTRATIVE CENTER DRIVE",
            "address_2": "PO BOX 09",
            "city": "COURTLAND",
            "state": "VA",
            "postal_code": "238370009",
            "telephone_number": "757-653-3040",
            "fax_number": "757-653-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26022 ADMINISTRATIVE CENTER DRIVE",
            "city": "COURTLAND",
            "state": "VA",
            "postal_code": "238370009",
            "telephone_number": "757-653-3040",
            "fax_number": "757-653-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "757-514-4765"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8450714",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008700681",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008770280",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497229",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4975952",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southampton County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Babb, FNP
• Believe in Me Mobile Phlebotomy Services, LLC
• Stacy Ann Brinkley, FNP
• Tenecia Renee Brown-Shearin
• Children'S Therapy Concepts LLC
• Courtland Hearing AIDS and Balance, LLC
• Courtland Operating LLC
• Courtland VA Opco LLC
• Joshua Alexander Diggins, ATC
• Savannah Francis

• State or Local Public Health Clinic/Center in Courtland, VA
• Providers in Courtland, VA by specialty
• State or Local Public Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.