Village Health Telehealth PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VILLAGE HEALTH TELEHEALTH PLLC

Practice address

3419 E Elena LN
Chattaroy, WA 99003-5121

Phone

(509) 960-6527

Fax

(833) 989-2072

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Jessica A. Blackwell, APRNNPI 1902859895

Title

Owner and Provider

Phone

(509) 960-6527

Specialties & licenses 1

Addresses

Other names 1

• eVillageHealth Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica A. Blackwell, ARNP

  • Primary Care Nurse Practitioner
  • Chattaroy, WA
  • NPI 1902859895
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1669087367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 E ELENA LN",
            "city": "CHATTAROY",
            "state": "WA",
            "postal_code": "990035121",
            "telephone_number": "509-960-6527",
            "fax_number": "833-989-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 E ELENA LN",
            "city": "CHATTAROY",
            "state": "WA",
            "postal_code": "990035121",
            "telephone_number": "509-960-6527",
            "fax_number": "833-989-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE HEALTH TELEHEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER AND PROVIDER",
        "authorized_official_telephone_number": "509-960-6527",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eVillageHealth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "eVillageHealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riverside School District
• Nathan P Stime, MD
• Victor S Stime, DDS
• Stonewall Residential Care, LLC
• Miriam Turney

• Primary Care Clinic/Center in Chattaroy, WA
• Providers in Chattaroy, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.