NPIMap

Organization Active NPI

Middle Peninsula Northern Neck CSB

  • Early Intervention Provider Agency
  • Urbanna, VA
National Provider Identifier
1295261444
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
PROV0641855 Issued in VA
Legal business name
MIDDLE PENINSULA NORTHERN NECK CSB
Practice address
5372 Old Virginia St
Suite B
Urbanna, VA 23175-2179
Phone
(804) 758-5250
Fax
(804) 758-5183
NPI assigned
May 10, 2017
Last updated
May 10, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
RURAL INFANT SERVICE PROGRAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Katherine Phillips, MAED
Title
Director
Phone
(804) 758-5250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X PROV0641855 VA Primary

Addresses

Primary practice location

5372 Old Virginia St
Suite B
Urbanna, VA 23175-2179

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4978137MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Middle Peninsula Northern Neck CSB6 organizations share this tax ID, including this one
Part of
Middle Peninsula Northern Neck CSB

Other organizations with this tax ID 5

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

Locations

5372 Old Virginia St
#B
Urbanna, VA 23175
Phone (804) 695-6670

Practitioners & affiliated clinicians

Practitioners 4

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": "1494374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1295261444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5372B OLD VIRGINIA ST",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "23175",
            "telephone_number": "804-758-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372 OLD VIRGINIA ST",
            "address_2": "SUITE B",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "231752179",
            "telephone_number": "804-758-5250",
            "fax_number": "804-758-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE PENINSULA NORTHERN NECK CSB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RURAL INFANT SERVICE PROGRAM",
        "enumeration_date": "2017-05-10",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "804-758-5250",
        "authorized_official_credential": "MAED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "VA",
            "license": "PROV0641855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4978137",
            "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 May 10, 2017; 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.