City of Petersburg

Primary specialty

AmbulanceTaxonomy code 341600000X

License

00483 Issued in VA

Legal business name

CITY OF PETERSBURG

Practice address

125 N Union St
Petersburg, VA 23803-3237

Phone

(804) 733-2328

NPI assigned

Sep 13, 2006

Last updated

May 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Michalek

Title

Captain EMS Coordinator

Phone

(804) 733-2328

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1467557900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W TABB ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033211",
            "telephone_number": "804-733-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N UNION ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033237",
            "telephone_number": "804-733-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PETERSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "MICHALEK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CAPTAIN EMS COORDINATOR",
        "authorized_official_telephone_number": "804-733-2328"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VA",
            "license": "00483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009014641",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "465715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chiro One Wellness Center of Petersburg LLC
• Vijaya Lakshmi Chirumamilla, M.D.
• Heather Chong, RPH
• Shauna Holland Christian, LPC, CSAC
• Michael W Cieslinski, M.D.
• Citywide Transportation LLC
• Coretha Marie Claiborn, CSAC,MAC,SAP,LSATP
• Laykeia Kapri Clanton
• Monique Alteriss Clark, QMHP
• Sonja Clark

• Ambulance in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.