NPIMap

Organization Active NPI

V&V Adult Group Home, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Chesapeake, VA
National Provider Identifier
1659764629
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
142101001 Issued in VA
Legal business name
V&V ADULT GROUP HOME, LLC
Practice address
1037 Sean Dr
Chesapeake, VA 23323-2727
Phone
(757) 439-0853
Fax
(757) 673-4877
NPI assigned
Mar 13, 2015
Last updated
Mar 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Authorized official

Name
Mr. Vernon Tyrone JohnsonNPI 1366836173
Title
Ceo
Phone
(757) 439-0853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 142101001 VA Primary

Addresses

Primary practice location

1037 Sean Dr
Chesapeake, VA 23323-2727

Mailing address

1037 Sean Dr
Chesapeake, VA 23323-2727
Phone (757) 439-0853

Other identifiers 1

IdentifierTypeStateIssuer
0162498072MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
VV Adult Group Home LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1659764629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 SEAN DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233232727",
            "telephone_number": "757-439-0853",
            "fax_number": "757-673-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 SEAN DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233232727",
            "telephone_number": "757-439-0853",
            "fax_number": "757-673-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V&V ADULT GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "TYRONE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-439-0853",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "142101001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162498072",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.