Active NPI
Wesley Eddins, OWNER
- Driver
- Virginia Beach, VA
National Provider Identifier
1730739848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 83751657
- Practice address
- 1308 Gravenhurst Cir
Virginia Beach, VA 23464-8660 - Phone
- (423) 930-3978
- Fax
- (757) 965-9777
- NPI assigned
- Sep 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 83751657 | TN | Primary |
Addresses
Primary practice location
1308 Gravenhurst Cir
Virginia Beach, VA 23464-8660
Mailing address
1308 Gravenhurst Cir
Virginia Beach, VA 23464-8660
Phone (757) 202-9863
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5150 | Other | AMBULATORY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | NA | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83751657 | TN | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568851200000",
"number": "1730739848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 GRAVENHURST CIR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648660",
"telephone_number": "757-202-9863",
"fax_number": "757-965-9777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 GRAVENHURST CIR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234648660",
"telephone_number": "423-930-3978",
"fax_number": "757-965-9777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDDINS",
"first_name": "WESLEY",
"credential": "OWNER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-19",
"last_updated": "2019-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "TN",
"license": "83751657",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMBULATORY",
"identifier": "5150",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "NA",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1308 Gravenhurst Cir",
"city": "Virginia Beach",
"state": "VA",
"country_code": "US",
"postal_code": "234648660",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.