NPIMap

Organization Active NPI

Heavenly Manor LLC

  • Community Health Worker
  • Hampton, VA
National Provider Identifier
1093416497
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
HEAVENLY MANOR LLC
Practice address
132 Burns St
Hampton, VA 23669-4610
Phone
(757) 771-1477
NPI assigned
Mar 13, 2023
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Shamecka Lawanda Dinkins, RN, MSN
Title
Owner
Phone
(757) 771-1477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X Primary

Addresses

Primary practice location

132 Burns St
Hampton, VA 23669-4610

Mailing address

132 Burns St
Hampton, VA 23669-4610
Phone (757) 771-1477

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1093416497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 BURNS ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694610",
            "telephone_number": "757-771-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 BURNS ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236694610",
            "telephone_number": "757-771-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "DINKINS",
        "authorized_official_first_name": "SHAMECKA",
        "authorized_official_middle_name": "LAWANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-771-1477",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.