NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

Doing business as Southwest Virginia Care Connection for Children

  • State or Local Public Health Clinic/Center
  • Bristol, VA
National Provider Identifier
1114015716
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Doing business as
Southwest Virginia Care Connection for Children
Practice address
15068 Lee Hwy
Suite 900
Bristol, VA 24202-4263
Phone
(276) 645-4900
Fax
(276) 645-4913
NPI assigned
Oct 10, 2006
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMONWEALTH OF VIRGINIA STATE BD OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Vanessa Walker-Harris, M.D.
Title
Director of Office of Family Health
Phone
(804) 864-7170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
State or Local Public Health Clinic/Center 261QP0905X VA Primary

Addresses

Primary practice location

15068 Lee Hwy
Suite 900
Bristol, VA 24202-4263

Mailing address

15068 Lee Hwy
Suite 900
Bristol, VA 24202-4263
Phone (276) 645-4900

Other identifiers 1

IdentifierTypeStateIssuer
004976550MedicaidVA

Other names 1

  • Southwest Virginia Care Connection for Children Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cville Albemarle Health163 organizations share this tax ID, including this one
Part of
Cville Albemarle Health

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

15068 Lee Hwy
Ste 900
Bristol, VA 24202
Phone (276) 645-4900

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1114015716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15068 LEE HWY",
            "address_2": "SUITE 900",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024263",
            "telephone_number": "276-645-4900",
            "fax_number": "276-645-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15068 LEE HWY",
            "address_2": "SUITE 900",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242024263",
            "telephone_number": "276-645-4900",
            "fax_number": "276-645-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMONWEALTH OF VIRGINIA STATE BD OF HEALTH",
        "enumeration_date": "2006-10-10",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "WALKER-HARRIS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR OF OFFICE OF FAMILY HEALTH",
        "authorized_official_telephone_number": "804-864-7170",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004976550",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Virginia Care Connection for Children",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.