NPIMap

Organization Active NPI

Lake Country Area Agency on Aging

  • Durable Medical Equipment & Medical Supplies
  • South Hill, VA
National Provider Identifier
1609953587
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LAKE COUNTRY AREA AGENCY ON AGING
Practice address
1105 W Danville St
South Hill, VA 23970-3501
Phone
(434) 447-7661
Fax
(434) 447-4074
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Authorized official

Name
Mrs. Gwen Hinzman
Title
President/Ceo
Phone
(434) 447-7661

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X ADC782951 VA
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X HC0-17668 VA
Respite Care 385H00000X HC0-17668 VA

Addresses

Primary practice location

1105 W Danville St
South Hill, VA 23970-3501

Mailing address

1105 W Danville St
South Hill, VA 23970-3501
Phone (434) 447-7661

Other identifiers 1

IdentifierTypeStateIssuer
9114629MedicaidVA

Other names 1

  • LCAAA Other name

National Provider Directory

National Provider Directory
Tax ID family
Lake Country Area Agency on Aging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500249600000",
    "number": "1609953587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W DANVILLE ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239703501",
            "telephone_number": "434-447-7661",
            "fax_number": "434-447-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W DANVILLE ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239703501",
            "telephone_number": "434-447-7661",
            "fax_number": "434-447-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY AREA AGENCY ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2017-07-17",
        "status": "A",
        "authorized_official_last_name": "HINZMAN",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "434-447-7661",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "VA",
            "license": "ADC782951",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "VA",
            "license": "HC0-17668",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "VA",
            "license": "HC0-17668",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9114629",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCAAA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Hill, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.