NPIMap

Organization Active NPI

Jewish Family Service of Tidewater, Incorporated

  • Home Health Agency
  • Virginia Beach, VA
National Provider Identifier
1790791176
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JEWISH FAMILY SERVICE OF TIDEWATER, INCORPORATED
Practice address
5000 Corporate Woods Dr
Suite 400
Virginia Beach, VA 23462-4429
Phone
(757) 321-2244
Fax
(757) 321-2260
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Lisa Denise Benjamin, CPA
Title
Cfo
Phone
(757) 321-2247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5000 Corporate Woods Dr
Suite 400
Virginia Beach, VA 23462-4429

Mailing address

5000 Corporate Woods Dr
Suite 400
Virginia Beach, VA 23462-4429
Phone (757) 321-2244

Other identifiers 3

IdentifierTypeStateIssuer
004974891MedicaidVA
008700435MedicaidVA
011608OtherVAANTHEM BLUE CROSS BLUE SH

National Provider Directory

National Provider Directory

Locations

7300 Newport Ave
Norfolk, VA 23505
Phone (757) 459-4640

6325 N Center Dr
Ste 203
Norfolk, VA 23502
Phone (257) 459-4640

260 Grayson Rd
Ste 200
Virginia Beach, VA 23462
Phone (757) 459-4640

5000 Corporate Woods Dr
Ste 400
Virginia Beach, VA 23462
Phone (757) 459-4640

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1790791176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CORPORATE WOODS DR",
            "address_2": "SUITE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624429",
            "telephone_number": "757-321-2244",
            "fax_number": "757-321-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CORPORATE WOODS DR",
            "address_2": "SUITE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624429",
            "telephone_number": "757-321-2244",
            "fax_number": "757-321-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH FAMILY SERVICE OF TIDEWATER, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-321-2247",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004974891",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008700435",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "011608",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "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 Mar 29, 2021; 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.