NPIMap

Organization Active NPI

Kuumba Community Health and Wellness Center Inc.

Doing business as New Horizons Healthcare

  • Pediatric Dentistry
  • Roanoke, VA
National Provider Identifier
1487393930
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
KUUMBA COMMUNITY HEALTH AND WELLNESS CENTER INC.
Doing business as
New Horizons Healthcare
Practice address
1502 Williamson Road NE
Roanoke, VA 24012
Phone
(540) 566-3719
Fax
(540) 204-4288
NPI assigned
Jun 2, 2022
Last updated
Jun 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
KUUMBA COMMUNITY HEALTH AND WELLNESS CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Jonathan Stewart
Title
Chief Executive Officer
Phone
(540) 362-0360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

1502 Williamson Road NE
Roanoke, VA 24012

Mailing address

3716 Melrose Avenue NW
Roanoke, VA 24017
Phone (540) 655-4948

Other names 1

  • New Horizons Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kuumba Community Health Wellness Inc8 organizations share this tax ID, including this one
Part of
Kuumba Community Health Wellness Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1502 Williamson Rd NE
Roanoke, VA 24012
Phone (540) 283-5025

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": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1487393930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVENUE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24017",
            "telephone_number": "540-655-4948",
            "fax_number": "540-566-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 WILLIAMSON ROAD NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24012",
            "telephone_number": "540-566-3719",
            "fax_number": "540-204-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUUMBA COMMUNITY HEALTH AND WELLNESS CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KUUMBA COMMUNITY HEALTH AND WELLNESS CENTER INC",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "540-362-0360"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Horizons Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Horizons Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.