NPIMap

Organization Active NPI

Middle Peninsula Northern Neck Mental Health & Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gloucester, VA
National Provider Identifier
1497717615
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION
Practice address
9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162
Phone
(804) 693-5068
Fax
(804) 693-7407
NPI assigned
Apr 4, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mrs. Yvonne M Wingrove, M.ED.
Title
Chief Financial Officer
Phone
(804) 693-5640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Mailing address

PO Box 269
Ark, VA 23003-0269
Phone (804) 693-5640

Other names 1

  • MIDDLE PENINSULA NORTHERN NECK COUNSELING CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031124000358 VA Part B Supplier - Clinic/Group Practice 1254235989 Receives reassigned benefits from 55 practitioners
Practice locations: Gloucester, VA; Saluda, VA; Tappahannock, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mid-Pen-N-N Counsel6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

5959 Fiddlers Green Rd
Gloucester, VA 23061

9228 George Washington Memorial Hwy
Gloucester, VA 23061
Phone (804) 693-5057

Practitioners & affiliated clinicians

Practitioners 87

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.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1497717615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269",
            "city": "ARK",
            "state": "VA",
            "postal_code": "230030269",
            "telephone_number": "804-693-5640",
            "fax_number": "804-693-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-693-5068",
            "fax_number": "804-693-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "WINGROVE",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "804-693-5640",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDDLE PENINSULA NORTHERN NECK COUNSELING CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.