F.C. of Virginia, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

F.C. OF VIRGINIA, INC

Doing business as

Intrepid USA Healthcare Services

Practice address

4510 Holland Office Park Ste 503
Virginia Beach, VA 23452-1140

Phone

(757) 787-7202

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

John M. Kunysz Jr.

Title

Ceo

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Locations

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1760993869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 KELLER SPRINGS RD STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750065911",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 HOLLAND OFFICE PARK STE 503",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521140",
            "telephone_number": "757-787-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.C. OF VIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "KUNYSZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "49D0886958",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Virginia Beach, VA
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• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.