NPIMap

Organization Active NPI

First Care Collaborative PLLC

  • Family Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1770190191
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FIRST CARE COLLABORATIVE PLLC
Practice address
4053 Taylor Rd Ste K
Chesapeake, VA 23321-5526
Phone
(757) 483-6401
Fax
(757) 686-3025
NPI assigned
Sep 29, 2020
Last updated
Dec 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
Teresa Glenn
Title
Practice Manager
Phone
(757) 483-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4053 Taylor Rd Ste K
Chesapeake, VA 23321-5526

Mailing address

4053 Taylor Rd Ste K
Chesapeake, VA 23321-5526
Phone (757) 483-6401

Other names 1

  • First Care PC Former legal business name

National Provider Directory

National Provider Directory

Locations

4053 Taylor Rd
Ste K
Chesapeake, VA 23321
Phone (757) 483-6401

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1770190191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 TAYLOR RD STE K",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215526",
            "telephone_number": "757-483-6401",
            "fax_number": "757-686-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 TAYLOR RD STE K",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215526",
            "telephone_number": "757-483-6401",
            "fax_number": "757-686-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CARE COLLABORATIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "757-483-6401"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Care PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "First Care PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.