Organization Active NPI

About Change

  • Exclusive Provider Organization
  • Woodbridge, VA
National Provider Identifier
1275896128
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
ABOUT CHANGE
Practice address
13662 Jefferson Davis Hwy
Woodbridge, VA 22191-2005
Phone
(919) 737-5600
NPI assigned
Jun 15, 2012
Last updated
Jun 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Ms. Nelgy Olivio
Title
Ceo
Phone
(919) 737-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X NU Primary

Addresses

Primary practice location

13662 Jefferson Davis Hwy
Woodbridge, VA 22191-2005

Mailing address

4833 Tommans TRL
Raleigh, NC 27616-0760

National Provider Directory

National Provider Directory
Tax ID family
About Change2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1275896128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 TOMMANS TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276160760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13662 JEFFERSON DAVIS HWY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912005",
            "telephone_number": "919-737-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABOUT CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "OLIVIO",
        "authorized_official_first_name": "NELGY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-737-5600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.