Individual provider Active NPI

Edwin A. Eisenbeis III, C.O.

  • Prosthetics Case Management
  • Newport News, VA
National Provider Identifier
1962696963
Registry record updated Sep 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
802 Lockwood Ave Ste B
Newport News, VA 23602-4479
Phone
(757) 833-0911
Fax
(757) 833-1099
NPI assigned
Sep 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X Primary

Addresses

Primary practice location

802 Lockwood Ave Ste B
Newport News, VA 23602-4479

Mailing address

802 Lockwood Ave Ste B
Newport News, VA 23602-4479
Phone (757) 833-0911

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

NPI Registry JSON

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

{
    "created_epoch": "1188604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188604800000",
    "number": "1962696963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LOCKWOOD AVE STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024479",
            "telephone_number": "757-833-0911",
            "fax_number": "757-833-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LOCKWOOD AVE STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024479",
            "telephone_number": "757-833-0911",
            "fax_number": "757-833-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBEIS",
        "first_name": "EDWIN",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "C.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-01",
        "last_updated": "2007-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2007; 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.