NPIMap

Organization Active NPI

District 19 Community Services Board

  • Early Intervention Provider Agency
  • Petersburg, VA
National Provider Identifier
1669970646
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
184 Issued in VA
Legal business name
DISTRICT 19 COMMUNITY SERVICES BOARD
Practice address
20 W Bank St Ste 5
Petersburg, VA 23803-3279
Phone
(804) 862-6082
Fax
(804) 862-6158
NPI assigned
Jan 25, 2018
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Mrs. Lisa A Newby
Title
Executive Assistant
Phone
(804) 862-6082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 184 VA Primary

Addresses

Primary practice location

20 W Bank St Ste 5
Petersburg, VA 23803-3279

Mailing address

20 W Bank St Ste 7
Petersburg, VA 23803-3279
Phone (804) 862-6082

National Provider Directory

National Provider Directory
Tax ID family
District 19 Community Services Board2 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.

Locations

20 W Bank St
Ste 5
Petersburg, VA 23803
Phone (804) 863-1689

20 W Bank St
Ste 7
Petersburg, VA 23803
Phone (804) 862-8054

Practitioners & affiliated clinicians

Practitioners 5

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": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1669970646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W BANK ST STE 7",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033279",
            "telephone_number": "804-862-6082",
            "fax_number": "804-862-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W BANK ST STE 5",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238033279",
            "telephone_number": "804-862-6082",
            "fax_number": "804-862-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTRICT 19 COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "NEWBY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "804-862-6082",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "VA",
            "license": "184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.