NPIMap

Organization Active NPI

FCC Petersburg

  • Health Service Clinic/Center
  • North Prince George, VA
National Provider Identifier
1508282864
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
FCC PETERSBURG
Practice address
1100 River Rd
North Prince George, VA 23860-1659
Phone
(804) 504-7200
NPI assigned
Mar 11, 2014
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Corinna Van
Title
Business Administrator
Phone
(804) 504-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

1100 River Rd
North Prince George, VA 23860-1659

Mailing address

PO Box 90026
Petersburg, VA 23804-9000
Phone (804) 504-7200

National Provider Directory

National Provider Directory
Tax ID family
Federal Transfer Center Oklahoma City49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

1100 River Rd
North Prince George, VA 23860
Phone (804) 504-7200

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1508282864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90026",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238049000",
            "telephone_number": "804-504-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 RIVER RD",
            "city": "NORTH PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238601659",
            "telephone_number": "804-504-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCC PETERSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "CORINNA",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "804-504-7200"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Prince George, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2014; 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.