Mid Atlantic Development Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MID ATLANTIC DEVELOPMENT SERVICES, LLC

Practice address

625 Piney Forest Rd
Danville, VA 24540-2867

Phone

(336) 448-8927

NPI assigned

Nov 1, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Matisse Witherspoon

Title

Ceo

Phone

(336) 448-8927

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1760994552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 BETHANY TRACE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271276843",
            "telephone_number": "336-448-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402867",
            "telephone_number": "336-448-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC DEVELOPMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "WITHERSPOON",
        "authorized_official_first_name": "MATISSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-448-8927",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Merricks, FNP
• Megan Merrill, MS, OTR/L
• Samuel V Mesaros, DDS
• Michael H Torres MD PC
• Alicen Mickle, M.S./SLP-CF
• Jose Ferreras Mier Jr., M.D., MPH
• Mikhail O. Chizhikov, MD, LLC
• Glenn R Milam
• Harry D Milam
• James T. Milam, M.D.

• Community/Behavioral Health Agency in Danville, VA
• Providers in Danville, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.