Guy R Ackerman

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

2705089862 Issued in VA

Practice address

21738 Magnolia Ave
Petersburg, VA 23803-2212

Phone

(804) 524-9097

Fax

(804) 524-9097

NPI assigned

Jun 11, 2009

Last updated

Jun 11, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1063649515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21738 MAGNOLIA AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238032212",
            "telephone_number": "804-524-9097",
            "fax_number": "804-524-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21738 MAGNOLIA AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238032212",
            "telephone_number": "804-524-9097",
            "fax_number": "804-524-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "GUY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "2705089862",
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "VA",
            "license": "2705089862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Modifications Contractor in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Home Modifications Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.