NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

Doing business as Petersburg Health Department

  • Public Health or Welfare Agency
  • Petersburg, VA
National Provider Identifier
1144339144
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Doing business as
Petersburg Health Department
Practice address
301 Halifax St
Petersburg, VA 23803-6335
Phone
(804) 863-1652
Fax
(804) 862-6126
NPI assigned
Aug 30, 2006
Last updated
Sep 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Dr. Kathryn A Rankin, MDNPI 1912975384
Title
District Health Director
Phone
(804) 863-1652

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X VA Primary

Addresses

Primary practice location

301 Halifax St
Petersburg, VA 23803-6335

Mailing address

301 Halifax St
Petersburg, VA 23803-6335
Phone (804) 863-1652

Other identifiers 6

IdentifierTypeStateIssuer
063849OtherVAANTHEM
42517OtherVASOUTHERN HEALTH
004975073MedicaidVA
85737OtherVAVIRGINIA PREMIER
41995OtherVAOPTIMA/SENTARA
45763OtherVACARENET

Other names 1

  • Petersburg Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000622 VA Part B Supplier - Clinic/Group Practice 0547174369 Receives reassigned benefits from 30 practitioners
45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Independence, VA; Prince George, VA; Jonesville, VA; Lawrenceville, VA; Lebanon, VA; Louisa, VA; Lynchburg, VA; Marion, VA…

Other NPIs on the same Medicare enrollment 45

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 45

National Provider Directory

National Provider Directory
Tax ID family
Dickenson Co Health Dep163 organizations share this tax ID, including this one

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

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1144339144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HALIFAX ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238036335",
            "telephone_number": "804-863-1652",
            "fax_number": "804-862-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALIFAX ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238036335",
            "telephone_number": "804-863-1652",
            "fax_number": "804-862-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "804-863-1652",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "063849",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "42517",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975073",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "85737",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA/SENTARA",
            "identifier": "41995",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENET",
            "identifier": "45763",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petersburg Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.