NPIMap

Organization Active NPI

Patrick Henry Hospital, Inc.

Doing business as Riverside Adult Daycare, Williamsburg

  • Adult Day Care Clinic/Center
  • Williamsburg, VA
National Provider Identifier
1629184072
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
PL005216 Issued in VA
Legal business name
PATRICK HENRY HOSPITAL, INC.
Doing business as
Riverside Adult Daycare, Williamsburg
Practice address
3435 John Tyler Hwy
Building 2, Suite a
Williamsburg, VA 23185-1457
Phone
(757) 565-5305
Fax
(757) 875-2070
NPI assigned
Aug 21, 2006
Last updated
Jan 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Authorized official

Name
Mr. Walter W Austin
Title
Senior VP, LTC
Phone
(757) 875-7846

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X PL005216 VA Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X PL005216 VA

Addresses

Primary practice location

3435 John Tyler Hwy
Building 2, Suite a
Williamsburg, VA 23185-1457

Mailing address

608 Denbigh Blvd
Suite 600
Newport News, VA 23608-4410
Phone (757) 875-2023

Other identifiers 1

IdentifierTypeStateIssuer
008730784MedicaidVA

Other names 1

  • Riverside Adult Daycare, Williamsburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Patrick Henry Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3435 John Tyler Hwy
#A
Williamsburg, VA 23185
Phone (757) 565-4054

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1629184072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BLVD",
            "address_2": "SUITE 600",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084410",
            "telephone_number": "757-875-2023",
            "fax_number": "757-875-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 JOHN TYLER HWY",
            "address_2": "BUILDING 2, SUITE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231851457",
            "telephone_number": "757-565-5305",
            "fax_number": "757-875-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK HENRY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SENIOR VP, LTC",
        "authorized_official_telephone_number": "757-875-7846",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "VA",
            "license": "PL005216",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "VA",
            "license": "PL005216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008730784",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Adult Daycare, Williamsburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverside Adult Daycare, Williamsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.