NPIMap

Organization Active NPI

Allstar Medical Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hampton, VA
National Provider Identifier
1336975598
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ALLSTAR MEDICAL SERVICES
Practice address
2112 Executive Dr
Hampton, VA 23666-2402
Phone
(757) 608-1397
NPI assigned
Sep 12, 2024
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLSTAR MEDICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Mattielou Gilliam
Title
Ceo
Phone
(757) 608-1397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

2112 Executive Dr
Hampton, VA 23666-2402

Mailing address

2112 Executive Dr
Hampton, VA 23666-2402
Phone (757) 608-1397

National Provider Directory

National Provider Directory
Tax ID family
Allstar Medical Services3 organizations share this tax ID, including this one
Part of
Allstar Medical Services

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1336975598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-608-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-608-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLSTAR MEDICAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLSTAR MEDICAL SERVICES",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "MATTIELOU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-608-1397"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.