NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

  • Public Health or Welfare Agency
  • Berryville, VA
National Provider Identifier
1629029640
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Practice address
100 N Buckmarsh St
Berryville, VA 22611-1010
Phone
(540) 955-1033
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Authorized official

Name
Mr. David D Crabtree, M.S
Title
District Administrator
Phone
(540) 722-3470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X VA Primary

Addresses

Primary practice location

100 N Buckmarsh St
Berryville, VA 22611-1010

Mailing address

10 Baker Street
Winchester, VA 22601-4828
Phone (540) 722-3470

Other identifiers 2

IdentifierTypeStateIssuer
324085OtherVAANTHEM/ HEALTHKEEPERS
004975405MedicaidVA

Other names 1

  • Clarke County Health Dept. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000414 VA Part B Supplier - Public Health/Welfare Agency 0547174369 Receives reassigned benefits from 6 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth of VA State163 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

100 N Buckmarsh St
Berryville, VA 22611
Phone (540) 955-1003

10 Baker St
Winchester, VA 22601
Phone (540) 722-3470

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1629029640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BAKER STREET",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226014828",
            "telephone_number": "540-722-3470",
            "fax_number": "540-722-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BUCKMARSH ST",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226111010",
            "telephone_number": "540-955-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "CRABTREE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DISTRICT ADMINISTRATOR",
        "authorized_official_telephone_number": "540-722-3470",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/ HEALTHKEEPERS",
            "identifier": "324085",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975405",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarke County Health Dept.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berryville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.