Active NPI
Commonwealth of Virginia Department of Behavi
Doing business as Eastern State Hospital
- Hospitalist Physician
- Williamsburg, VA
National Provider Identifier
1518064922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- Legal business name
- COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI
- Doing business as
- Eastern State Hospital
- Practice address
- 4601 Ironbound Rd
Williamsburg, VA 23188-2652 - Phone
- (757) 253-5241
- Fax
- (757) 253-5065
- NPI assigned
- Sep 20, 2006
- Last updated
- Jun 6, 2011
- Organization subpart
- Yes
- Parent organization
- COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AN
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jack L. Wood, NHA
- Title
- Hospital Director
- Phone
- (757) 253-5241
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | Primary |
Addresses
Primary practice location
4601 Ironbound Rd
Williamsburg, VA 23188-2652
Mailing address
4601 Ironbound Rd
Williamsburg, VA 23188-2652
Phone (757) 253-5241
Other names 1
- Eastern State Hospital
National Provider Directory
National Provider Directory- Part of
- Commonwealth of Virgini
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1307318400000",
"number": "1518064922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 IRONBOUND RD",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231882652",
"telephone_number": "757-253-5241",
"fax_number": "757-253-5065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 IRONBOUND RD",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231882652",
"telephone_number": "757-253-5241",
"fax_number": "757-253-5065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AN",
"enumeration_date": "2006-09-20",
"last_updated": "2011-06-06",
"status": "A",
"authorized_official_last_name": "WOOD",
"authorized_official_first_name": "JACK",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "HOSPITAL DIRECTOR",
"authorized_official_telephone_number": "757-253-5241",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "NHA"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Eastern State Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Williamsburg, VA
- Comfort Embrace Home Healthcare, LLC
- Commonwealth of Virginia Department of Behavi (Eastern State Hospital)
- Commonwealth of Virginia Department of Behavi (Eastern State Hospital)
- Commonwealth of Virginia Department of Behavi (Eastern State Hospital)
- Commonwealth of Virginia Department of Behavi (Eastern State Hospital)
- Communication Therapy LLC
- Compassionate Heartspace, LLC
- Complete Therapeutic Solutions, LLC
- Concierge and Companies Inc
- Hannah Michelle Conn
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.