NPIMap

Organization Active NPI

Innovage Virginia Pace II, LLC

  • PACE Provider Organization
  • Richmond, VA
National Provider Identifier
1124512637
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
INNOVAGE VIRGINIA PACE II, LLC
Practice address
1300 Mactavish Ave
Richmond, VA 23230-4633
Phone
(804) 977-5990
NPI assigned
Jun 18, 2018
Organization subpart
Yes
Parent organization
TOTAL COMMUNITY OPTIONS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Authorized official

Name
Ms. Maureen Hewitt
Title
Ceo
Phone
(303) 869-4664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X VA Primary

Addresses

Primary practice location

1300 Mactavish Ave
Richmond, VA 23230-4633

Mailing address

8950 E Lowry Blvd
Denver, CO 80230-7030
Phone (303) 869-4664

Other names 2

  • InnovAge Virgina PACE-Peninsula Doing business as
  • InnovAge Virginia PACE - Newport Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Innovage2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1124512637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 E LOWRY BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307030",
            "telephone_number": "303-869-4664",
            "fax_number": "303-996-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MACTAVISH AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304633",
            "telephone_number": "804-977-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVAGE VIRGINIA PACE II, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOTAL COMMUNITY OPTIONS INC.",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "HEWITT",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-869-4664",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnovAge Virgina PACE-Peninsula",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "InnovAge Virginia PACE - Newport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 18, 2018; 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.