Envoy of Goochland, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ENVOY OF GOOCHLAND, LLC

Practice address

2715 Dogtown Rd
Goochland, VA 23063-2424

Phone

(804) 556-4418

NPI assigned

Nov 3, 2008

Organization subpart

No

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

Authorized official

Name

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Envoy at the Meadows Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1104079243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 DOGTOWN RD",
            "city": "GOOCHLAND",
            "state": "VA",
            "postal_code": "230632424",
            "telephone_number": "804-556-4418",
            "fax_number": "804-556-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 DOGTOWN RD",
            "city": "GOOCHLAND",
            "state": "VA",
            "postal_code": "230632424",
            "telephone_number": "804-556-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVOY OF GOOCHLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104079243",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Envoy at the Meadows",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Envoy at the Meadows",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Goochland, VA
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.