NPIMap

Organization Active NPI

Commonwealth of VA Hiram W Davis Medical Center

  • Skilled Nursing Facility
  • Petersburg, VA
National Provider Identifier
1184732083
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMMONWEALTH OF VA 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 29, 2006
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
Skilled Nursing Facility 314000000X 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
4957504MedicaidVA

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
O20100628000267 VA Part A Provider - Skilled Nursing Facility 2163401399 Practice locations: Petersburg, VA

Skilled nursing facility certification: CCN 495113

Legal name
COMMONWEALTH OF VA HIRAM W DAVIS MEDICAL CENTER
Doing business as
HIRAM W. DAVIS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Apr 16, 1978
Last certification
Mar 17, 2022
Beds
90
Ownership / control type
State
Multi-facility organization
Department of Behavioral Health and Development Services
Organization structure
GovernmentNon-profit
Enrollment address
26317 W Washington Street
Petersburg, VA 23803-0030
Nursing home name
HIRAM W DAVIS MEDICAL CTR

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: Nursing home

Medicare Care Compare
Listed as
Hiram W Davis Medical CtrCCN 495113
Overall star rating
4 of 5
Health inspections
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Apr 16, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9027.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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.

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
Vickie M Brewer Individual W-2 Managing EmployeeMedical Administrative Assistant Nov 25, 2021
Jarvis Griffin Individual Corporate DirectorLnha/Ceo Jan 11, 2021

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1184732083",
    "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": "2006-08-29",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4957504",
            "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.