Individual provider Active NPI

Ebony Williams Poindexter, LMT

  • Community Health Worker
  • Virginia Beach, VA
National Provider Identifier
1497090633
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
919643436 Issued in VA
Practice address
228 N Lynnhaven Rd
Suite 107
Virginia Beach, VA 23452-7514
Phone
(757) 340-5814
NPI assigned
Nov 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 919643436 VA Primary

Addresses

Primary practice location

228 N Lynnhaven Rd
Suite 107
Virginia Beach, VA 23452-7514

Mailing address

2124 Whitley Abbey Dr
Virginia Beach, VA 23456-5753
Phone (757) 749-2209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
919643436VAMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1497090633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 WHITLEY ABBEY DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234565753",
            "telephone_number": "757-749-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 N LYNNHAVEN RD",
            "address_2": "SUITE 107",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527514",
            "telephone_number": "757-340-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POINDEXTER",
        "first_name": "EBONY",
        "middle_name": "WILLIAMS",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "VA",
            "license": "919643436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.