Lucy Corr Foundation, Inc.

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

LUCY CORR FOUNDATION, INC.

Practice address

6800 Lucy Corr Blvd.
Chesterfield, VA 23832-6657

Phone

(804) 467-2255

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Tammy Holbert Shackelford

Title

Executive Director

Phone

(804) 467-2255

Specialties & licenses 1

Addresses

Other names 1

• Lucy Corr Dental Clinic Other name

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1689243537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 LUCY CORR BLVD.",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-467-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 LUCY CORR BLVD.",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326657",
            "telephone_number": "804-467-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCY CORR FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "HOLBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-467-2255",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucy Corr Dental Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Public Health Dentistry in Chesterfield, VA
• Providers in Chesterfield, VA by specialty
• Public Health Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.