NPIMap

Organization Active NPI

Martha Jefferson Hospital

  • Durable Medical Equipment & Medical Supplies
  • Charlottesville, VA
National Provider Identifier
1912228628
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MARTHA JEFFERSON HOSPITAL
Doing business as
The Something Special Shop
Practice address
500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone
(434) 654-7042
NPI assigned
Jun 16, 2010
Organization subpart
Yes
Parent organization
MARTHA JEFFERSON HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Melinda Summerlin Hancock
Title
Cfo
Phone
(757) 455-7458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668

Mailing address

590 Peter Jefferson Pkwy Ste 300
Charlottesville, VA 22911-4628
Phone (434) 654-8574

Other identifiers 1

IdentifierTypeStateIssuer
4900774MedicaidVA

Other names 1

  • The Something Special Shop Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000225 VA DME Supplier - Medical Supply Company 1557279742 Practice locations: Charlottesville, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Martha Jefferson Med SV7 organizations share this tax ID, including this one
Part of
Martha Jefferson Med SV

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1912228628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 PETER JEFFERSON PKWY STE 300",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114628",
            "telephone_number": "434-654-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA JEFFERSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTHA JEFFERSON HOSPITAL",
        "enumeration_date": "2010-06-16",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUMMERLIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-455-7458"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4900774",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Something Special Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.