Organization Active NPI

Dpmstraleyprva,LLC

  • Foot & Ankle Surgery Podiatrist
  • Newport News, VA
National Provider Identifier
1235337437
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103300928 Issued in VA
Legal business name
DPMSTRALEYPRVA,LLC
Practice address
705 Mobjack PL
Suite B
Newport News, VA 23606-1966
Phone
(757) 873-2101
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Authorized official

Name
Mrs. Rhonda Richardson
Title
Office Manager
Phone
(757) 873-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 0103300928 VA Primary

Addresses

Primary practice location

705 Mobjack PL
Suite B
Newport News, VA 23606-1966

Mailing address

705 Mobjack PL
Suite B
Newport News, VA 23606-1966
Phone (757) 873-2101

Other identifiers 2

IdentifierTypeStateIssuer
010221862MedicaidVA
185871OtherVAANTHEM BLUE CROSS BLUE SH

National Provider Directory

National Provider Directory

Locations

705 Mobjack Pl
Ste B
Newport News, VA 23606
Phone (307) 683-7627

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1235337437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MOBJACK PL",
            "address_2": "SUITE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061966",
            "telephone_number": "757-873-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MOBJACK PL",
            "address_2": "SUITE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061966",
            "telephone_number": "757-873-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPMSTRALEYPRVA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-873-2101",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103300928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010221862",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "185871",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.