NPIMap

Organization Active NPI

Edgewood Group Family Services

  • Community/Behavioral Health Agency
  • Richmond, VA
National Provider Identifier
1962720060
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
709-11 Issued in VA
Legal business name
EDGEWOOD GROUP FAMILY SERVICES
Practice address
4906 Fitzhugh Ave
Suite 104
Richmond, VA 23230-3526
Phone
(804) 648-0671
Fax
(804) 648-0672
NPI assigned
May 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Authorized official

Name
Mr. William Travis Crocker, QMHP
Title
Ceo
Phone
(804) 921-4611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 709-11 VA Primary

Addresses

Primary practice location

4906 Fitzhugh Ave
Suite 104
Richmond, VA 23230-3526

Mailing address

4906 Fitzhugh Ave
Suite 104
Richmond, VA 23230-3526
Phone (804) 648-0671

National Provider Directory

National Provider Directory
Tax ID family
Edgewood Group Family Services24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273708800000",
    "number": "1962720060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 FITZHUGH AVE",
            "address_2": "SUITE 104",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303526",
            "telephone_number": "804-648-0671",
            "fax_number": "804-648-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 FITZHUGH AVE",
            "address_2": "SUITE 104",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303526",
            "telephone_number": "804-648-0671",
            "fax_number": "804-648-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD GROUP FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TRAVIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-921-4611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "709-11",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.