NPIMap

Organization Active NPI

Kingdom Dominion LLC

  • Community/Behavioral Health Agency
  • Danville, VA
National Provider Identifier
1992099873
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
905-02-014 Issued in VA
Legal business name
KINGDOM DOMINION LLC
Practice address
633 Newton St
Danville, VA 24541-2019
Phone
(804) 525-4345
Fax
(804) 562-7752
NPI assigned
Jun 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Mr. Anthony L Walker
Title
Owner
Phone
(804) 525-4345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 905-02-014 VA Primary

Addresses

Primary practice location

633 Newton St
Danville, VA 24541-2019

Mailing address

633 Newton St
Danville, VA 24541-2019
Phone (804) 525-4345

National Provider Directory

National Provider Directory
Tax ID family
Kingdom Dominion LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

633 Newton St
Danville, VA 24541
Phone (434) 425-2928

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1992099873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 NEWTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412019",
            "telephone_number": "804-525-4345",
            "fax_number": "804-562-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 NEWTON ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412019",
            "telephone_number": "804-525-4345",
            "fax_number": "804-562-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM DOMINION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-525-4345",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "905-02-014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.