Keystone Newport News, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

KEYSTONE NEWPORT NEWS, LLC

Doing business as

Newport News Behavioral Health Center

Practice address

17579 Warwick Blvd
Newport News, VA 23603-1343

Phone

(757) 888-0400

Fax

(757) 888-0359

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Larry Kirkland, MS, LMHC

Title

Ceo

Phone

(757) 888-0400

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Newport News Behavioral Health Center Doing business as

Tax ID family

Keystone Newport News2 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.

• Keystone Newport News

  dba Newport News Behavioral Health Center

  • Mental Illness Community Based Residential Treatment Facility
  • Newport News, VA
  • NPI 1306389184
  NPD tax ID

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Avtar S Dhillon, M.D.

  • Psychiatry Physician
  • Williamsburg, VA
  • NPI 1134210784
  NPD (past)
• John G Phocas III, MD

  • Psychiatry Physician
  • Newport News, VA
  • NPI 1043283443
  NPD (past)
• Norriece Liana Piggott, M.D.

  • Psychiatry Physician
  • Newport News, VA
  • NPI 1962763573
  NPD (past)
• Damian Thomas Tucker

  • Professional Counselor
  • Newport News, VA
  • NPI 1184271132
  NPD (past)
• Brad Z. Berger, M.D.

  • Child & Adolescent Psychiatry Physician
  • Gulfport, MS
  • NPI 1609883347
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625184000000",
    "number": "1356360580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17579 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23603",
            "telephone_number": "757-888-0400",
            "fax_number": "757-888-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17579 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236031343",
            "telephone_number": "757-888-0400",
            "fax_number": "757-888-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE NEWPORT NEWS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-888-0400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LMHC"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416531400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA DEPT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES",
            "identifier": "84114001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0505002000",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0505002000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035597400",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA DEPT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES",
            "identifier": "84114003",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport News Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Ronald Kersh, MD
• Connie Swartz Ketten, M.D.
• Youngshin Keum
• Joelle Lynn Keyser, CRNP
• Keystone Newport News (Newport News Behavioral Health Center)
• Jawwad Jahangir Khan, M.D.
• Mehtab Singh Khara
• Anwar Khedr, MBCHB
• Jonathan Khoury, M.D.
• Aishah Naomi Khursheed, LMFT, LPC

• Mental Illness Community Based Residential Treatment Facility in Newport News, VA
• Providers in Newport News, VA by specialty
• Mental Illness Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.