NPIMap

Organization Active NPI

Chesterfield Community Services Board-Infant Program

  • Early Intervention Provider Agency
  • Richmond, VA
National Provider Identifier
1497884969
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
CHESTERFIELD COMMUNITY SERVICES BOARD-INFANT PROGRAM
Practice address
101 Buford Road
Suite 110
Richmond, VA 23235
Phone
(804) 748-1227
Fax
(804) 717-6659
NPI assigned
Mar 2, 2007
Last updated
May 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Authorized official

Name
Ms. Deborah Burcham
Title
Executive Director
Phone
(804) 768-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X VA Primary

Addresses

Primary practice location

101 Buford Road
Suite 110
Richmond, VA 23235

Mailing address

101 Buford Road
Suite 110
Richmond, VA 23235
Phone (804) 748-1227

Other identifiers 1

IdentifierTypeStateIssuer
1497884969MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621000919 VA Part B Supplier - Clinic/Group Practice 0547245946 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chesterfield, VA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Chesterfield County Mental Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

101 Buford Rd
Ste 110
North Chesterfield, VA 23235
Phone (804) 447-6382

9711 Farrar Ct
Ste 140
North Chesterfield, VA 23236
Phone (804) 768-7205

Practitioners & affiliated clinicians

Practitioners 7

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1497884969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BUFORD ROAD",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BUFORD ROAD",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-748-1227",
            "fax_number": "804-717-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTERFIELD COMMUNITY SERVICES BOARD-INFANT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "BURCHAM",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-768-7220",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497884969",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.