Active NPI
Thomas Amos Elliott
- Home Modifications Contractor
- Tappahannock, VA
National Provider Identifier
1841307212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 2705057306
- Practice address
- Pob 1191
1113 Daingerfield St
Tappahannock, VA 22560-1191 - Phone
- (703) 861-4997
- Fax
- (804) 445-1914
- NPI assigned
- Aug 23, 2006
- Last updated
- May 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 2705057306 | VA | Primary |
Addresses
Primary practice location
Pob 1191
1113 Daingerfield St
Tappahannock, VA 22560-1191
Mailing address
Pob 1191
1113 Daingerfield Street
Tappahannock, VA 22560-1191
Phone (571) 501-8865
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010029759 | Other | VA | PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2705057306 | VA | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1841307212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POB 1191",
"address_2": "1113 DAINGERFIELD STREET",
"city": "TAPPAHANNOCK",
"state": "VA",
"postal_code": "225601191",
"telephone_number": "571-501-8865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "POB 1191",
"address_2": "1113 DAINGERFIELD ST",
"city": "TAPPAHANNOCK",
"state": "VA",
"postal_code": "225601191",
"telephone_number": "703-861-4997",
"fax_number": "804-445-1914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "THOMAS",
"middle_name": "AMOS",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "VA",
"license": "2705057306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER #",
"identifier": "010029759",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tappahannock, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.