NPIMap

Organization Active NPI

Commonwealth of Virginia Central State Hospital

  • Hospitalist Physician
  • Petersburg, VA
National Provider Identifier
1457415291
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
COMMONWEALTH OF VIRGINIA CENTRAL STATE HOSPITAL
Practice address
26317 W Washington Street
Petersburg, VA 23803
Phone
(804) 524-7000
NPI assigned
Dec 19, 2006
Organization subpart
Yes
Parent organization
CENTRAL STATE HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Charles Davis, M.D.
Title
Facility Director
Phone
(804) 524-7373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

26317 W Washington Street
Petersburg, VA 23803

Mailing address

PO Box 4030
Petersburg, VA 23803-0030
Phone (804) 524-7373

Other names 1

  • Central State Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of VA CNTR2 organizations share this tax ID, including this one
Part of
Commonwealth of VA CNTR

Other organizations with this tax ID 1

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1457415291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4030",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238030030",
            "telephone_number": "804-524-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26317 W WASHINGTON STREET",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "804-524-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA CENTRAL STATE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL STATE HOSPITAL",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "FACILITY DIRECTOR",
        "authorized_official_telephone_number": "804-524-7373",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central State Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.