Professional Parent Care LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

S352074-1 Issued in VA

Legal business name

PROFESSIONAL PARENT CARE LLC

Practice address

317 N Rosemont Rd
Suite 103
Virginia Beach, VA 23452-3449

Phone

(757) 323-2865

Fax

(757) 962-4855

NPI assigned

May 31, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Keith Rydell Owens

Title

Secretary

Phone

(757) 778-5787

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1801180443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N ROSEMONT RD",
            "address_2": "SUITE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523449",
            "telephone_number": "757-323-2865",
            "fax_number": "757-962-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N ROSEMONT RD",
            "address_2": "SUITE 103",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523449",
            "telephone_number": "757-323-2865",
            "fax_number": "757-962-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PARENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RYDELL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "757-778-5787",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "VA",
            "license": "S352074-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Health Maintenance Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.