Chris Gollub

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

3945 Doe Run Rd
North Prince George, VA 23860-8771

Phone

(804) 898-5946

NPI assigned

Aug 4, 2022

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1386371888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 FLORIDA AVE",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245044809",
            "telephone_number": "804-898-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 DOE RUN RD",
            "city": "NORTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238608771",
            "telephone_number": "804-898-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLUB",
        "first_name": "CHRIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "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": "3945 Doe Run Rd",
            "city": "North Prince George",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238608771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Controlled Outcomes
• Andrew Edmonds
• Jana Leigh Ellis IX
• FCC Petersburg
• Follow Your Heart
• Sangok Gollub
• Anjelica Dee Harris, LMT
• Robin Heilbrun, R.PH.
• Sandra Hill
• Rakera Shunay Jackson

• Attendant Care Provider in North Prince George, VA
• Providers in North Prince George, 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 Aug 4, 2022; 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.