DESARAE LATEVA JEFFERSON (NPI# 1114559077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114559077 |
| Entity Type | Individual |
| Full Name | DESARAE LATEVA JEFFERSON |
| Practice Address |
4357 Roark Mill Rd Hurt VA 24563-3308 |
| Practice Telephone | 4344208823 |
| Practice Fax Number | 4343240568 |
| Mailing Telephone | 4344208823 |
| Mailing Fax Number | 4343240568 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 347C00000X | Private Vehicle | T60727635 | VA | Transportation Services |
| Street Address |
4357 ROARK MILL RD |
| City | HURT |
| State | VA |
| Zip Code | 24563-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902282098 | David Drew Pociluyko | Physical Therapist | 527 Pocket Rd, Hurt, VA 24563 | 2015-07-31 |
| 1770766628 | Dr Al N Angle II & Associates Optometrists | Optometrist | 221-d Staunton Plaza Shopping Center, Hurt, VA 24563-0610 | 2007-12-14 |
| 1588728711 | Randall G Roelfs | Optometrist | Staunton Plaza Shopping Center, Hurt, VA 24563-0610 | 2006-12-21 |
| 1316139884 | Guy Wilson Walton Jr. | Dentist | 221 Main St., Suite A, Hurt, VA 24563-0820 | 2007-08-17 |
| 1255339123 | Sandy J Robertson | Family Medicine | 527 Pocket Rd, Hurt, VA 24563-2023 | 2005-07-13 |
| 1295354587 | Tanner Len Cooke | Physical Therapist | 527 Pocket Rd, Hurt, VA 24563-2023 | 2020-04-16 |
| 1548725419 | Joelyn Arthur Cunningham | Physical Therapist | 527 Pocket Rd, Hurt, VA 24563-2023 | 2019-02-05 |
| 1982157798 | Brian Britt | Physical Therapist | 527 Pocket Rd, Hurt, VA 24563-2023 | 2016-07-28 |
| 1669852885 | Joshua Carapezza | Physician Assistant | 527 Pocket Rd, Hurt, VA 24563-2023 | 2015-06-03 |
| 1710232897 | Jessica G Moran | Physical Therapist | 527 Pocket Rd, Hurt, VA 24563-2023 | 2012-07-16 |
| Find all providers in zip 24563 | ||||
| Taxonomy Code | 347C00000X |
| Grouping | Transportation Services |
| Classification | Private Vehicle |
| An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972119808 | Mercy Transports LLC | Private Vehicle | 3212 Mechanicsville Turnpike, Mechanicsville, VA 23111 | 2020-09-16 |
| 1992321517 | Kenneth Bell | Private Vehicle | 47 Gainsborough Pl, Newport News, VA 23608-2029 | 2020-06-19 |
| 1720601065 | Tenea Latrice Walker | Private Vehicle | 2780 Mahixon Rd, Manquin, VA 23106-2318 | 2020-05-21 |
| 1649892589 | Shanique Washington | Private Vehicle | 2247 Dellrose Dr Apt A, Hopewell, VA 23860-7205 | 2020-05-14 |
| 1164044103 | Cornell Daniel Bailey | Private Vehicle | 1016 Level Green Blvd, Virginia Beach, VA 23464-4509 | 2020-05-13 |
| 1427684950 | Michelle Denise Young | Private Vehicle | 1228 Golden Leaf Rd, Nathalie, VA 24577-3494 | 2020-03-17 |
| 1083248884 | Lowell D. Evans | Private Vehicle | 114 Pine Shores Ln, Huddleston, VA 24104-3155 | 2020-03-02 |
| 1841823713 | Rachel Nicole Davis | Private Vehicle | 529 Freeze Rd, Danville, VA 24540-2135 | 2020-02-19 |
| 1235762345 | Michael E Shannon | Private Vehicle | 7928 Brown Mountain Rd, Jewell Ridge, VA 24622-8640 | 2020-02-17 |
| 1821621228 | Marlon Reyes | Private Vehicle | 2500 Pump Rd, Richmond, VA 23233 | 2020-02-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.