NPIMap

Organization Active NPI

Middle Peninsula Northern Neck Community Services Board

  • Case Manager/Care Coordinator
  • Urbanna, VA
National Provider Identifier
1245547264
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
171M00000X Issued in VA
Legal business name
MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD
Practice address
5372B Old Virginia Street
Urbanna, VA 23175
Phone
(804) 758-5250
Fax
(804) 758-5183
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Elizabeth Middleton Taylor, Q.M.R.P.
Title
Care Coordinator/Case Manager
Phone
(804) 758-5250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X 171M00000X VA Primary

Addresses

Primary practice location

5372B Old Virginia Street
Urbanna, VA 23175

Mailing address

PO Box 40
Saluda, VA 23149-0040
Phone (804) 758-5250

Other identifiers 1

IdentifierTypeStateIssuer
49-7813-7MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Middle Peninsula Northern Neck Mental Health Retardation6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

5372B Old Virginia St
Urbanna, VA 23175
Phone (804) 758-5250

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1245547264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SALUDA",
            "state": "VA",
            "postal_code": "231490040",
            "telephone_number": "804-758-5250",
            "fax_number": "804-758-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372B OLD VIRGINIA STREET",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "23175",
            "telephone_number": "804-758-5250",
            "fax_number": "804-758-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MIDDLETON",
        "authorized_official_title_or_position": "CARE COORDINATOR/CASE MANAGER",
        "authorized_official_telephone_number": "804-758-5250",
        "authorized_official_credential": "Q.M.R.P."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "VA",
            "license": "171M00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49-7813-7",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbanna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.