Glance Avon Neal II

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

3610 Cappahosic Rd
Gloucester, VA 23061-3313

Phone

(804) 210-1783

NPI assigned

Oct 21, 2019

Last updated

Oct 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1376186536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 CAPPAHOSIC RD",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613313",
            "telephone_number": "804-210-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 CAPPAHOSIC RD",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613313",
            "telephone_number": "804-210-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "GLANCE",
        "middle_name": "AVON",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "3610 Cappahosic Rd",
            "city": "Gloucester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "230613313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alicia Sierra Moss, M.A., CF -SLP
• Victor Morgan Moss Jr., ED.S.,LPC, LMFT, NCC
• David W Muffelman, M.D.
• Kyung-Mi Lim Murphy, M.D.
• Myt Holistic PLLC
• Jerrid Neeley
• Blair Williams Nein, NP
• Dennis Pernell Nelson
• John-Mike Nelson, L.P.C.
• Patricia Ann Nelson

• Attendant Care Provider in Gloucester, VA
• Providers in Gloucester, VA by specialty
• Attendant Care Provider in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.