Individual provider Active NPI

Yinka Lawal

  • Contractor
  • Chester, VA
National Provider Identifier
1174094759
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
13355 Castlewellan Dr
Chester, VA 23836-2904
Phone
(804) 720-5164
NPI assigned
Dec 7, 2018
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X NU Primary

Addresses

Primary practice location

13355 Castlewellan Dr
Chester, VA 23836-2904

Mailing address

13355 Castlewellan Dr
Chester, VA 23836-2904
Phone (804) 720-5164

Other practice location 1

10400 Chester Rd Ste 204
Chester, VA 23831-1205
Phone (804) 720-5164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Citagroup LLC CurrentSince Apr 16, 2023 Accepting new patients
Citagroup LLC Current Accepting new patients

Locations

10400 Chester Rd
Ste 204
Chester, VA 23831
Phone (804) 720-5164

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1174094759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13355 CASTLEWELLAN DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362904",
            "telephone_number": "804-720-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 CASTLEWELLAN DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238362904",
            "telephone_number": "804-720-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Chester Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "VA",
            "postal_code": "238311205",
            "country_code": "US",
            "telephone_number": "804-720-5164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWAL",
        "first_name": "YINKA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-07",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.