Organization Active NPI

New Life, LLC

  • Community/Behavioral Health Agency
  • Newport News, VA
National Provider Identifier
1710234240
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1729 Issued in VA
Legal business name
NEW LIFE, LLC
Practice address
11030 Warwick Blvd BLDG B
Newport News, VA 23601-3250
Phone
(757) 595-3890
Fax
(757) 595-3891
NPI assigned
Aug 15, 2012
Last updated
Aug 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Mr. Richard E Roman
Title
Cao
Phone
(757) 595-3890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1729 VA Primary

Addresses

Primary practice location

11030 Warwick Blvd BLDG B
Newport News, VA 23601-3250

Mailing address

11030 Warwick Blvd BLDG B
Newport News, VA 23601-3250
Phone (757) 595-3890

Other practice location 1

610 Thimble Shoals Blvd Ste 201D
Newport News, VA 23606-2573
Phone (757) 595-3890

Other practice location 2

2020 E Franklin St Ste A
Richmond, VA 23223-7372
Phone (804) 824-6074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190528002014 VA Part B Supplier - Clinic/Group Practice 2163765512 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Newport News, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
New Life LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

610 Thimble Shoals Blvd
Ste 201D
Newport News, VA 23606
Phone (757) 595-3890

2020 E Franklin St
Ste A
Richmond, VA 23223
Phone (804) 824-6074

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": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1710234240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 WARWICK BLVD BLDG B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013250",
            "telephone_number": "757-595-3890",
            "fax_number": "757-595-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 WARWICK BLVD BLDG B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013250",
            "telephone_number": "757-595-3890",
            "fax_number": "757-595-3891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Thimble Shoals Blvd Ste 201D",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236062573",
            "country_code": "US",
            "telephone_number": "757-595-3890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 E Franklin St Ste A",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232237372",
            "country_code": "US",
            "telephone_number": "804-824-6074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "757-595-3890",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.