Divine Health Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0017000454 Issued in VA

Legal business name

DIVINE HEALTH CARE, LLC

Doing business as

Divine Health Care, LLC

Practice address

2207 Executive Dr
Ste B
Hampton, VA 23666-2478

Phone

(757) 826-1600

Fax

(757) 826-0160

NPI assigned

Jan 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Debra Foster Chinnery, EDD, FNPNPI 1225127582

Title

Owner

Phone

(757) 826-0514

Specialties & licenses 1

Addresses

Other names 1

• Divine Health Care, LLC 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.

• Debra F Chinnery, EDD, FNP, BC

  • Nurse Practitioner
  • Hampton, VA
  • NPI 1225127582
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1053659714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2207 EXECUTIVE DR",
            "address_2": "STE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662478",
            "telephone_number": "757-826-1600",
            "fax_number": "757-826-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2207 EXECUTIVE DR",
            "address_2": "STE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662478",
            "telephone_number": "757-826-1600",
            "fax_number": "757-826-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "CHINNERY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "FOSTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-826-0514",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0017000454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Health Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Farid Ud Din, MD
• Monica Dipaola, DPT
• Distinctively Me LLC
• Diverse Healthcare Inc
• Diversified Community Services Inc
• Divine Home Health Care LLC
• Lindia Batten Dixon, RN
• Michael Wesley Dixon, IDC
• Walter D Dixon, MD
• Tam Thi Minh DO, MD

• Primary Care Clinic/Center in Hampton, VA
• Providers in Hampton, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.