Everett Service Provider

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

EVERETT SERVICE PROVIDER

Practice address

2503 Woodrow St
Portsmouth, VA 23707-2124

Phone

(757) 793-0146

Fax

(757) 368-3647

NPI assigned

Aug 6, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Susan E. Vick, LPN

Title

President

Phone

(757) 235-0463

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1619309226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 WOODROW ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072124",
            "telephone_number": "757-793-0146",
            "fax_number": "757-368-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 WOODROW ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072124",
            "telephone_number": "757-793-0146",
            "fax_number": "757-368-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT SERVICE PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-235-0463",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.