Commonwealth of Virginia Department of Behavi

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI

Practice address

4601 Ironbound Rd
Williamsburg, VA 23188-2652

Phone

(757) 253-5241

Fax

(757) 253-5065

NPI assigned

Sep 25, 2006

Organization subpart

Yes

Parent organization

COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH ANAs reported in NPPES

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

Authorized official

Name

Mr. Jack L. Wood, NHA

Title

Hospital Director

Phone

(757) 253-5241

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eastern State Hospital Doing business as

Part of

Commonwealth of Virgini

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1205936614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 IRONBOUND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882652",
            "telephone_number": "757-253-5241",
            "fax_number": "757-253-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 IRONBOUND RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882652",
            "telephone_number": "757-253-5241",
            "fax_number": "757-253-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AN",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "HOSPITAL DIRECTOR",
        "authorized_official_telephone_number": "757-253-5241",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004901096",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC 423",
            "identifier": "007814",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern State Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Acute Care Hospital in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• General Acute Care Hospital in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.