Kim Wright

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

4267-14-008 Issued in VA

Practice address

3810 W Hundred Rd
Chester, VA 23831-1930

Phone

(804) 318-1484

NPI assigned

Apr 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lighthouse 1 LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Chester, VA
  • NPI 1346937976

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD Authorized official

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1619663440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 W HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311930",
            "telephone_number": "804-318-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 W HUNDRED RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311930",
            "telephone_number": "804-318-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": "4267-14-008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Wong, DDS
• WP Chesterfield Health Investors, LLC
• Nicole Wray, MOTR/L
• Carl D Wright, PA
• Charlotte Wright, MA, CCC-SLP
• Randi D Wright, PT, DPT
• TSZ L Wu
• Amanda Yarbrough
• Keilah Yisrael
• David J Young II

• Emotionally Disturbed Childrens' Residential Treatment Facility in Chester, VA
• Providers in Chester, VA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.