NPIMap

Organization Active NPI

Commonwealth of VA Hiram W Davis Medical Center

Doing business as Hiram W Davis Medical Center

  • General Acute Care Hospital
  • Petersburg, VA
National Provider Identifier
1174630081
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
COMMONWEALTH OF VA HIRAM W DAVIS MEDICAL CENTER
Doing business as
Hiram W Davis Medical Center
Practice address
26317 W Washington St
Petersburg, VA 23803-0030
Phone
(804) 524-7112
Fax
(804) 524-4831
NPI assigned
Aug 24, 2006
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Dr. Jarvis T Griffin, DHA, LNHA, CPHQ
Title
Facility Director/Ceo
Phone
(804) 524-7112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

26317 W Washington St
Petersburg, VA 23803-0030

Mailing address

PO Box 4030
Petersburg, VA 23803-0030
Phone (804) 524-7112

Other identifiers 1

IdentifierTypeStateIssuer
4901045MedicaidVA

Other names 1

  • Hiram W Davis Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000337 VA Part A Provider - Hospital 2163401399 Practice locations: Petersburg, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174630081. Details of each certification follow.

Hospital certification: CCN 490104

Legal name
COMMONWEALTH OF VA HIRAM W DAVIS MEDICAL CENTER
Doing business as
HIRAM W DAVIS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 4, 1967
Last certification
Sep 12, 2002
Beds
10
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
26317 West Washington St
Petersburg, VA 23803-0030
Other Hospital Practice Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Hiram W Davis Medical CenterCCN 490104 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of VA Hiram W Davis Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

26317 Washington St
North Dinwiddie, VA 23803
Phone (804) 524-7000

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hilton McDaniel Individual Corporate Director Sep 25, 2019
Bonnie Stalnaker Individual W-2 Managing Employee Sep 12, 2016

Practitioners & affiliated clinicians

Practitioners 4

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1174630081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4030",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238030030",
            "telephone_number": "804-524-7112",
            "fax_number": "804-524-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 W WASHINGTON ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238030030",
            "telephone_number": "804-524-7112",
            "fax_number": "804-524-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VA HIRAM W DAVIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JARVIS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "FACILITY DIRECTOR/CEO",
        "authorized_official_telephone_number": "804-524-7112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DHA, LNHA, CPHQ"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4901045",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hiram W Davis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hiram W Davis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.