NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

Doing business as Pulaski County Health Department

  • Public Health or Welfare Agency
  • Pulaski, VA
National Provider Identifier
1639284979
Registry record updated Nov 29, 2023
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
Doing business as
Pulaski County Health Department
Practice address
170 4TH St NW
Pulaski, VA 24301-4524
Phone
(540) 994-5030
Fax
(540) 994-5036
NPI assigned
Aug 19, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Noelle Bissell, MDNPI 1861475311
Title
Health Director
Phone
(540) 381-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

170 4TH St NW
Pulaski, VA 24301-4524

Mailing address

170 4TH St NW
Pulaski, VA 24301-4524
Phone (540) 994-5030

Other identifiers 1

IdentifierTypeStateIssuer
004975880MedicaidVA

Other names 1

  • Pulaski County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111118000313 VA Part B Supplier - Public Health/Welfare Agency 0547174369 Receives reassigned benefits from 1 practitioner
Practice locations: Pulaski, VA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Cville Albemarle Health163 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

109 Governor St
Fl 13
Richmond, VA 23219
Phone (804) 864-7009

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1639284979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 4TH ST NW",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243014524",
            "telephone_number": "540-994-5030",
            "fax_number": "540-994-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 4TH ST NW",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "243014524",
            "telephone_number": "540-994-5030",
            "fax_number": "540-994-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-11-29",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BISSELL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "540-381-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004975880",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pulaski County Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pulaski County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pulaski, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.