Organization Active NPI

Amerigroup Corporation

  • Health Maintenance Organization
  • Virginia Beach, VA
National Provider Identifier
1962485540
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
AMERIGROUP CORPORATION
Practice address
4425 Corporation LN
Virginia Beach, VA 23462-3103
Phone
(757) 962-6452
Fax
(757) 222-2377
NPI assigned
Nov 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jmaes Gorden Carlson
Title
President
Phone
(757) 962-6452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

4425 Corporation LN
Virginia Beach, VA 23462-3103

Mailing address

4425 Corporation LN
Virginia Beach, VA 23462-3103
Phone (757) 962-6452

National Provider Directory

National Provider Directory

Locations

4425 Corporation Ln
Virginia Beach, VA 23462
Phone (757) 473-2737

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962485540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 CORPORATION LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623103",
            "telephone_number": "757-962-6452",
            "fax_number": "757-222-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 CORPORATION LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623103",
            "telephone_number": "757-962-6452",
            "fax_number": "757-222-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIGROUP CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JMAES",
        "authorized_official_middle_name": "GORDEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-962-6452",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.