SP Williamsburg, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2742 Issued in VA

Legal business name

SP WILLIAMSBURG, LLC

Doing business as

Tandem Health Care at Williamsburg

Practice address

1811 Jamestown Rd
Williamsburg, VA 23185-2326

Phone

(757) 229-9991

Fax

(757) 229-9509

NPI assigned

Jun 10, 2006

Last updated

Aug 22, 2020By 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

Joseph Conte

Title

Chief Operating Officer

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tandem Health Care at Williamsburg Doing business as

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073555785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CONCOURSE PKWY S",
            "address_2": "SUITE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516148",
            "telephone_number": "407-571-1550",
            "fax_number": "407-571-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 JAMESTOWN RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852326",
            "telephone_number": "757-229-9991",
            "fax_number": "757-229-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP WILLIAMSBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONTE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4959906",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tandem Health Care at Williamsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eboni Nicole Soule, PMHNP
• Southeastern Healthcare, LLC (BrightStar Healthcare)
• Southerncare, Inc. (New Century Hospice - Williamsburg)
• Katelyn Southwell, CMT
• SP Williamsburg Health Investors
• Kelly Oliver Spann, NP
• Specialed Navigator PLLC (SpecialEd Navigator)
• Speech Language Intervention Strategies Speechlis (Speechlis, LLC)
• Speechluxe, LLC
• John Hobart Speegle, DDS

• Skilled Nursing Facility in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.