NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

  • Public Health or Welfare Agency
  • Chesterfield, VA
National Provider Identifier
1477572626
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Practice address
9501 Lucy Corr Cir
Chesterfield, VA 23832-6697
Phone
(804) 748-1743
Fax
(804) 751-4497
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Mrs. Paulette A Moore
Title
Business Manager
Phone
(804) 748-1630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

9501 Lucy Corr Cir
Chesterfield, VA 23832-6697

Mailing address

PO Box 100
Chesterfield, VA 23832-0002
Phone (804) 748-1743

Other identifiers 5

IdentifierTypeStateIssuer
004975189MedicaidVA
4975189OtherVIRGINIA PREMIER HEALTH
12470OtherVACARENET/SOUTHERN HEALTH
266457OtherVAANTHEM BLUE CROSS/BSHIELD
41174OtherOPTIMA FAMILY CARE

Other names 1

  • Chesterfield Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000414 VA Part B Supplier - Public Health/Welfare Agency 0547174369 Receives reassigned benefits from 6 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of VA State163 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

9501 Lucy Corr Cir
Chesterfield, VA 23832
Phone (804) 748-1743

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1477572626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238320002",
            "telephone_number": "804-748-1743",
            "fax_number": "804-751-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 LUCY CORR CIR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326697",
            "telephone_number": "804-748-1743",
            "fax_number": "804-751-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PAULETTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "804-748-1630",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975189",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH",
            "identifier": "4975189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARENET/SOUTHERN HEALTH",
            "identifier": "12470",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS/BSHIELD",
            "identifier": "266457",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA FAMILY CARE",
            "identifier": "41174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesterfield Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.