Hampton-Newport News Community Services Board

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

HAMPTON-NEWPORT NEWS COMMUNITY SERVICES BOARD

Doing business as

Aberdeen ICF

Practice address

1421 Aberdeen Rd
Hampton, VA 23666-4027

Phone

(757) 251-2244

Fax

(757) 224-4950

NPI assigned

Jun 13, 2019

Last updated

Jun 13, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

HAMPTON-NEWPORT NEWS COMMUNITY SERVICES BOARDAs reported in NPPES

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

Authorized official

Name

Yaisa Onika Goodwin

Title

Credentialing/Procurement Coordinat

Phone

(757) 788-0065

Specialties & licenses 1

Addresses

Other names 1

• Aberdeen ICF Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821657719. Details of each certification follow.

• CCN 49G075 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G075

Legal name

ABERDEEN GARDENS

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

May 23, 2019

Last certification

Sep 16, 2022

Beds

4

Ownership / control type

Private (non-profit)

Facility address

1421 Aberdeen Road
Hampton, VA 23666

Part of

Hampton Roads Clinic

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Hampton Newport News Community Services Board

  • Community/Behavioral Health Agency
  • Hampton, VA
  • NPI 1659424448
  NPPES parent name

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560384000000",
    "number": "1821657719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661765",
            "telephone_number": "757-788-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 ABERDEEN RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236664027",
            "telephone_number": "757-251-2244",
            "fax_number": "757-224-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMPTON-NEWPORT NEWS COMMUNITY SERVICES BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAMPTON-NEWPORT NEWS COMMUNITY SERVICES BOARD",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "YAISA",
        "authorized_official_middle_name": "ONIKA",
        "authorized_official_title_or_position": "CREDENTIALING/PROCUREMENT COORDINAT",
        "authorized_official_telephone_number": "757-788-0065"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aberdeen ICF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hampton VA Medical Center
• Hampton Vamc
• Hampton Vamc
• Hampton Vamc
• Hampton Vamc
• Lakisha Hampton
• Hamton Oral & Facial Surgery
• Lois Hancock, M.S.N., C.N.M.
• Chad Ryan Handley, DC
• Valdimir Handy

• Intellectual Disabilities Intermediate Care Facility in Hampton, VA
• Providers in Hampton, VA by specialty
• Intellectual Disabilities Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.