NPIMap

Organization Active NPI

Long Term Care of America-Virginia, Inc.

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1104902386
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LONG TERM CARE OF AMERICA-VIRGINIA, INC.
Practice address
5000 Monument Ave
Suite 102
Richmond, VA 23230-3600
Phone
(804) 593-5146
Fax
(804) 477-7243
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Dr. Marc G Nevin, MD
Title
President
Phone
(804) 593-5146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5000 Monument Ave
Suite 102
Richmond, VA 23230-3600

Mailing address

5000 Monument Ave
Suite 102
Richmond, VA 23230-3600
Phone (804) 593-5146

Other identifiers 1

IdentifierTypeStateIssuer
005609241MedicaidVA

National Provider Directory

National Provider Directory

Locations

5000 Monument Ave
Ste 102
Richmond, VA 23230
Phone (804) 593-5140

1308 W Main St
Salem, VA 24153
Phone (540) 387-1209

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1104902386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 MONUMENT AVE",
            "address_2": "SUITE 102",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303600",
            "telephone_number": "804-593-5146",
            "fax_number": "804-477-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MONUMENT AVE",
            "address_2": "SUITE 102",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303600",
            "telephone_number": "804-593-5146",
            "fax_number": "804-477-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TERM CARE OF AMERICA-VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "NEVIN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-593-5146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005609241",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.