NPIMap

Organization Active NPI

Chippenham & Johnston-Willis Hospitals, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Richmond, VA
National Provider Identifier
1366689747
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.
Practice address
1401 Johnston Willis Dr
Richmond, VA 23235-4730
Phone
(804) 267-6814
Fax
(804) 330-2325
NPI assigned
Jan 7, 2009
Last updated
Jun 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Dustin Fosness
Title
Cfo
Phone
(804) 483-0813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X Primary

Addresses

Primary practice location

1401 Johnston Willis Dr
Richmond, VA 23235-4730

Mailing address

1401 Johnston Willis Dr
Richmond, VA 23235-4730
Phone (804) 267-6814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040831000405 VA Part B Supplier - Clinic/Group Practice 9032105010 Receives reassigned benefits from 53 practitioners
2 other NPIs on this enrollment
Practice locations: North Chesterfield, VA; North Chesterfiled, VA; Richmond, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chippenham Johnston Wil14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Member organizations 6

Organizations listed as members of this organization in the National Provider Directory.

Locations

7300 Beaufont Spring Dr
Ste 101
North Chesterfield, VA 23225

Practitioners & affiliated clinicians

Practitioners 54

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.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1366689747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-267-6814",
            "fax_number": "804-330-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-267-6814",
            "fax_number": "804-330-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPENHAM & JOHNSTON-WILLIS HOSPITALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "FOSNESS",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-483-0813"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.