NPIMap

Organization Active NPI

Goodwill Industries of the Valleys - Radford

Doing business as New River Valley Workshop

  • Developmentally Disabled Services Day Training Agency
  • Radford, VA
National Provider Identifier
1285762229
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
010343101 Issued in VA
Legal business name
GOODWILL INDUSTRIES OF THE VALLEYS - RADFORD
Doing business as
New River Valley Workshop
Practice address
103 Duncan Lane
Radford, VA 24141
Phone
(540) 639-9027
Fax
(540) 639-3517
NPI assigned
Mar 1, 2007
Last updated
May 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Mr. Bruce Phipps
Title
President and Ceo
Phone
(540) 581-0620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 010343101 VA Primary

Addresses

Primary practice location

103 Duncan Lane
Radford, VA 24141

Mailing address

2502 Melrose Avenue NW
Suite a
Roanoke, VA 24017
Phone (540) 581-0620

Other identifiers 1

IdentifierTypeStateIssuer
010343101MedicaidVA

Other names 1

  • New River Valley Workshop Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goodwill Industries of the Valleys4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

103 Duncan Ln
Radford, VA 24141
Phone (540) 639-9027

2502 Melrose Ave NW
#A
Roanoke, VA 24017

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1285762229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 MELROSE AVENUE NW",
            "address_2": "SUITE A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24017",
            "telephone_number": "540-581-0620",
            "fax_number": "540-581-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 DUNCAN LANE",
            "city": "RADFORD",
            "state": "VA",
            "postal_code": "24141",
            "telephone_number": "540-639-9027",
            "fax_number": "540-639-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF THE VALLEYS - RADFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "540-581-0620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": "010343101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010343101",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New River Valley Workshop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Radford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.