NPIMap

Organization Active NPI

Boydton Community Health Facility Inc

Doing business as Boydton Dental Center

  • Federally Qualified Health Center (FQHC)
  • Boydton, VA
National Provider Identifier
1114184546
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BOYDTON COMMUNITY HEALTH FACILITY INC
Doing business as
Boydton Dental Center
Practice address
1329 Jefferson Street
Boydton, VA 23917
Phone
(434) 738-0729
Fax
(434) 738-6982
NPI assigned
May 22, 2008
Last updated
Jul 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Authorized official

Name
Angela N Miller
Title
Executive Director
Phone
(434) 738-6102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1329 Jefferson Street
Boydton, VA 23917

Mailing address

PO Box 540
Boydton, VA 23917-0540
Phone (434) 738-6102

Other identifiers 1

IdentifierTypeStateIssuer
007691092MedicaidVA

Other names 1

  • Boydton Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Boydton Community Health Facility Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1114184546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 540",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "239170540",
            "telephone_number": "434-738-6102",
            "fax_number": "434-738-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 JEFFERSON STREET",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-0729",
            "fax_number": "434-738-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYDTON COMMUNITY HEALTH FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "434-738-6102"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007691092",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boydton Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boydton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.