Ethos House Calls Practice
Organization Active NPI Primary Care Clinic/Center · Lanexa, VA
NPI 1558049429 · NPPES record last updated Jul 10, 2023
Key facts
- NPI
- 1558049429
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Joan Elizabeth Benton, NP-C
- Title
- NP
- Phone
- (757) 719-0621
Practitioners 1
-
Joan Elizabeth Benton, NP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2298096 | Ethos House Calls | Certificate of waiver | Jan 28, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231220002341 | VA | Part B Supplier - Clinic/Group Practice | 9032569892 |
Receives reassigned benefits from 1 practitioner Practice locations: Newport News, VA; Lanexa, VA |
National Provider Directory
Locations
733 Thimble Shoals Blvd
Ste 170
Newport News, VA 23606
Phone (757) 537-8224
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
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
Other providers in Lanexa, VA
- Kelsey Jo Barbour
- Joan Elizabeth Benton
- Susan Cameron
- Franciscan Brethren of St. Philip Inc Little Sisters of St. F
- Rebecca Leigh Johnson
- Katherine Cowins Lindsey
- Jennifer Erin Lutterloh
- Pathway Therapy Specialists LLC
All providers in Lanexa, VA · Primary Care Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.