NPIMap

Organization Active NPI

Southern Dominion Health System Inc

Doing business as Housecalls for the Homebound

  • Federally Qualified Health Center (FQHC)
  • Victoria, VA
National Provider Identifier
1467630731
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHERN DOMINION HEALTH SYSTEM INC
Doing business as
Housecalls for the Homebound
Practice address
1508 K V Road
Victoria, VA 23974-0070
Phone
(434) 696-2165
Fax
(434) 696-1557
NPI assigned
Feb 8, 2008
Last updated
Feb 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Dr. Scott O. Davis, LCSWNPI 1871735043
Title
Ceo
Phone
(434) 696-2165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1508 K V Road
Victoria, VA 23974-0070

Mailing address

PO Box 70
Victoria, VA 23974-0070
Phone (434) 696-2165

Other identifiers 1

IdentifierTypeStateIssuer
007691084MedicaidVA

Other names 1

  • Housecalls for the Homebound Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1467630731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 K V ROAD",
            "city": "VICTORIA",
            "state": "VA",
            "postal_code": "239740070",
            "telephone_number": "434-696-2165",
            "fax_number": "434-696-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DOMINION HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "434-696-2165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007691084",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Housecalls for the Homebound",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.