SP Lafayette Villa LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2603 Issued in VA

Legal business name

SP LAFAYETTE VILLA LLC

Practice address

3900 Llewellyn Ave
Norfolk, VA 23504-1203

Phone

(757) 625-5363

Fax

(757) 627-3161

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Joseph Conte

Title

Chief Operating Officer

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tandem Health Care of Norfolk Doing business as

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689616096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CONCOURSE PKWY S",
            "address_2": "SUITE 200",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327516148",
            "telephone_number": "407-571-1550",
            "fax_number": "407-571-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LLEWELLYN AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041203",
            "telephone_number": "757-625-5363",
            "fax_number": "757-627-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP LAFAYETTE VILLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONTE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4952731",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tandem Health Care of Norfolk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynne Southern, CRNA
• Southerncare , Inc.
• Southside Ambulance Service LLC
• Patrick Sowa, MD
• Valerie Sowder, LCSW
• Kimberly Mary Span, MD
• Kristen Jeanne Spanik, RD, CDE
• Kyle Allen Spanik, PA-C
• Karen Yvette Spann, MED
• James P Sparrer, MD

• Skilled Nursing Facility in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.