MRS. IDA TRICE VACLAVIK


Address: 601 Watkins Centre Pkwy, Suite 200, Midlothian, VA 23114-0002
Phone: 8045943130

MRS. IDA TRICE VACLAVIK (NPI# 1134408644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134408644
Entity Type Individual
Full Name MRS. IDA TRICE VACLAVIK
Other Name MISS IDA SAWYER TRICE
Credential NP
Practice Address 601 Watkins Centre Pkwy
Suite 200
Midlothian
VA 23114-0002
Practice Telephone 8045943130
Practice Fax Number 8044236517
Mailing Telephone 8045943130
Mailing Fax Number 8044236517
Enumeration Date 2011-08-15
Last Update Date 2015-05-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
0024172575 VA Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
RN1008705 DC Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
VA GROUP PTAN C09633 01

Office Location

Street Address 601 WATKINS CENTRE PKWY
SUITE 200
City MIDLOTHIAN
State VA
Zip Code 23114-0002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407035629 Misti H Wilson Surgery 601 Watkins Centre Pkwy, Suite 200, Midlothian, VA 23114-0002 2007-10-25
1235505439 Sean O'laughlin Nurse Practitioner 601 Watkins Centre Pkwy, Midlothian, VA 23114-0002 2015-08-11
1942479803 Eric Floranda Psychiatry & Neurology 601 Watkins Centre Pkwy, Suite 250, Midlothian, VA 23114-0002 2008-02-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174122162 Jotava In Home Supportive Care 1607 Titanium Avenue, 202, Midlothian, VA 23114 2020-10-20
1104393735 Shelley Hurwitz Occupational Therapist 13800 Bon Secours Drive, Midlothian, VA 23114 2018-11-01
1316412182 Snehal Manmeet Mahajan Physical Therapist 13800 Bon Secours Dr., Midlothian, VA 23114 2018-10-09
1154814796 Bon Secours St Francis Medical Center Inc. Clinic/Center 13700 St Francis Blvd Ste 105, Midlothian, VA 23114 2018-06-08
1023516630 Leah Reed Occupational Therapist 13800 Bon Secours Dr, Midlothian, VA 23114 2018-01-29
1689122012 Momentum Counseling and Wellness LLC Social Worker 431 Walton Park Road, Midlothian, VA 23114 2016-09-14
1750765996 Arlene Roper Physical Therapy Assistant 1700 Redbourne Ct, Apt 101, Midlothian, VA 23114 2015-07-17
1518353937 Tamaika Floy Podiatrist 611 Watkins Centre Pkwy Ste 170, Midlothian, VA 23114 2015-04-13
1760790489 Markita Wolf Psychologist 831 Grove Rd Ste C, Midlothian, VA 23114 2010-09-15
1306153119 Jacinda Beth Chaisson Physical Therapist 13700 St. Francis Blvd., Suite 103, Midlothian, VA 23114 2010-09-01
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730799917 Darnesha Shaunte Clanton Nurse Practitioner 401 Rockaway Dr, Midlothian, TX 76065-1199 2020-08-03
1740816685 Anjalyse Maria Valenti Nurse Practitioner 542 Glenpark Ln, Midlothian, VA 23114-3067 2020-03-22
1861027419 Mussie Futwi Mebrahtu Nurse Practitioner 214 Canterbury Ct, Midlothian, TX 76065-1417 2020-03-04
1457996167 Elizabeth Murray Nurse Practitioner 1230 Alverser Dr Ste 104, Midlothian, VA 23113-2653 2019-11-18
1487214508 Genevieve R. Matulin Nurse Practitioner 14319 Jeffries Pl, Midlothian, VA 23114-4359 2019-06-20
1780243329 Brandi Hartsfield Nurse Practitioner 531 Totten Dr, Midlothian, VA 23113-3440 2019-06-07
1023675741 Aisha Tate-odom Nurse Practitioner 14506 Spaulding Ave, Midlothian, IL 60445-3020 2019-05-29
1659861961 Shaquita I. Alexander Nurse Practitioner 6204 Crowne Creek Dr, Midlothian, VA 23112-8315 2018-05-11
1245751874 Kristyn Janine Childress Nurse Practitioner 14500 Needham Market Rd, Midlothian, VA 23112-1683 2017-07-05
1124567581 Crystal Mann Nurse Practitioner 12000 Old Bailey Bridge Rd, Midlothian, VA 23112-3120 2017-02-18
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Competitor

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City MIDLOTHIAN
Zip Code 23114

Improve Information

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Dataset Information

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.

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