Organization Active NPI

Ethos House Calls Practice

  • Primary Care Clinic/Center
  • Lanexa, VA
National Provider Identifier
1558049429
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ETHOS HOUSE CALLS PRACTICE
Practice address
7337 Old Camp Rd
Lanexa, VA 23089-5133
Phone
(757) 719-0621
NPI assigned
Jul 10, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Mrs. Joan Elizabeth Benton, NP-CNPI 1902073612
Title
NP
Phone
(757) 719-0621

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7337 Old Camp Rd
Lanexa, VA 23089-5133

Mailing address

7337 Old Camp Rd
Lanexa, VA 23089-5133
Phone (757) 719-0621

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231220002341 VA Part B Supplier - Clinic/Group Practice 9032569892 Receives reassigned benefits from 1 practitioner
Practice locations: Newport News, VA; Lanexa, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2298096Ethos House Calls7337 Old Camp Rd, Lanexa, VA 23089Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1558049429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 OLD CAMP RD",
            "city": "LANEXA",
            "state": "VA",
            "postal_code": "230895133",
            "telephone_number": "757-719-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7337 OLD CAMP RD",
            "city": "LANEXA",
            "state": "VA",
            "postal_code": "230895133",
            "telephone_number": "757-719-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HOUSE CALLS PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "757-719-0621",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanexa, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.