Commonwealth of Virginia State Board of Health

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

Practice address

3810 Nine Mile Rd
Henrico, VA 23223-4848

Phone

(804) 652-3186

Fax

(804) 501-4588

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carla P. Bennett

Title

Business Manager

Phone

(804) 501-4953

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Henrico Health Department - East Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1508951567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 NINE MILE RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232234848",
            "telephone_number": "804-652-3186",
            "fax_number": "804-501-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 NINE MILE RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232234848",
            "telephone_number": "804-652-3186",
            "fax_number": "804-501-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "804-501-4953",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68428",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "072212",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10001587",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4975588",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henrico Health Department - East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Commonshare, Inc
• Commonwealth Behavioral Health Services
• Commonwealth Eye Care Associates PC
• Commonwealth Gastroenterology, PC
• Commonwealth of Virginia State Board of Health
• Commonwealth Pain Management and Wellness, PLLC
• Community Assistance Network, LLC
• Companions
• Compassionate Hearts Homecare
• Sean Concannon, LCSW

• Public Health or Welfare Agency in Henrico, VA
• Providers in Henrico, VA by specialty
• Public Health or Welfare Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; 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.