Active NPI
About Change
- Exclusive Provider Organization
- Woodbridge, VA
National Provider Identifier
1275896128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- 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, 2012
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 Change
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Woodbridge, VA
- NPI 1033512199
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.
-
- Case Manager/Care Coordinator
- Kissimmee, FL
- NPI 1326483959
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.