NPIMap

Organization Active NPI

Total Life Center of Southside Virginia

  • Community Health Worker
  • Crewe, VA
National Provider Identifier
1275257487
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
TOTAL LIFE CENTER OF SOUTHSIDE VIRGINIA
Practice address
5963 Namozine Rd
Crewe, VA 23930-2734
Phone
(817) 879-1048
NPI assigned
Sep 30, 2022
Last updated
Sep 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Mrs. Tammy Moore Oakes
Title
Executive Director
Phone
(434) 321-3569

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

5963 Namozine Rd
Crewe, VA 23930-2734

Mailing address

5963 Namozine Rd
Crewe, VA 23930-2734
Phone (817) 879-1048

Other names 1

  • TLCSOVA Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1664496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1275257487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5963 NAMOZINE RD",
            "city": "CREWE",
            "state": "VA",
            "postal_code": "239302734",
            "telephone_number": "817-879-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5963 NAMOZINE RD",
            "city": "CREWE",
            "state": "VA",
            "postal_code": "239302734",
            "telephone_number": "817-879-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LIFE CENTER OF SOUTHSIDE VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "OAKES",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "434-321-3569",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLCSOVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Crewe, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.