CHAZ LAMAR CLYBURN (NPI# 1346886504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346886504 |
| Entity Type | Individual |
| Full Name | CHAZ LAMAR CLYBURN |
| Practice Address |
5217 Shady Grove Ln Virginia Beach VA 23462-1787 |
| Practice Telephone | 7578007806 |
| Mailing Telephone | 7578007806 |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2019-12-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | AETNA | MEBS3R6R | 01 |
| Street Address |
5217 SHADY GROVE LN |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-1787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912534082 | Cheyenne James | Counselor | 297 Independence Blvd., Virginia Beach, VA 23462 | 2020-03-26 |
| 1245871011 | Marathon Transportation Services LLC | Non-emergency Medical Transport (VAN) | 4505 Main Street, Apt 259, Virginia Beach, VA 23462 | 2019-10-03 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1801387808 | Matrixx Healthcare LLC | Respite Care | 405 S Parliament Dr Ste 106, Virginia Beach, VA 23462 | 2018-05-24 |
| 1518471671 | Newtown Chiropractic Center Pllc | Clinic/Center | 5777 Princess Ann Road, Virginia Beach, VA 23462 | 2017-11-28 |
| 1528587995 | Gary Lee Alexander II | Counselor | 870 N Newtown Road, Virginia Beach, VA 23462 | 2017-09-16 |
| 1801328810 | Servitium Med Va, LLC | Durable Medical Equipment & Medical Supplies | 4445 Corporation Lane Suite 291, Virginia Beach, VA 23462 | 2017-03-29 |
| 1215476171 | Johnnie Walter Cox IIi | Emergency Medical Technician, Basic | 5163 Cleveland Street, Virginia Beach, VA 23462 | 2017-02-13 |
| 1225570179 | Holly Balsamo | Occupational Therapy Assistant | 5345 Marian Lane, Virginia Beach, VA 23462 | 2016-11-09 |
| Find all providers in zip 23462 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184263113 | Goal Succeeders | Adult Companion | 4401 Virginia Beach Blvd, Virginia Beach, VA 23462-3106 | 2019-12-20 |
| 1932422623 | Kimberly Renee Hughes | Adult Companion | 1200 Madras Ct, Virginia Beach, VA 23454-5784 | 2010-03-09 |
| 1770125072 | Ruth Louise Anderson | Adult Companion | 900 Commonwealth Pl Ste 217, Virginia Beach, VA 23464-4529 | 2019-10-09 |
| 1013238849 | Clearview Services, LLC | Adult Companion | 4551 Professional Cir Ste 102, Virginia Beach, VA 23455-6442 | 2010-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871107862 | Kendra Johnson | Adult Companion | 5940 Sentry Hill Ct # 9b, North Dinwiddie, VA 23803-7400 | 2020-09-07 |
| 1972114429 | Angel Florine Pye | Adult Companion | 1712 Princeton Ave, Norfolk, VA 23523-2332 | 2020-08-10 |
| 1972113199 | Hannah Beyan | Adult Companion | 13800 Coppermine Rd # 103, Herndon, VA 20171-6163 | 2020-08-03 |
| 1922632157 | Keith Stradford | Adult Companion | 1340 County Pond Rd, Freeman, VA 23856-2604 | 2020-02-26 |
| 1407491244 | Clarissa Phillips | Adult Companion | 9254 Three Chopt Rd Apt C, Henrico, VA 23229-4049 | 2019-11-15 |
| 1528603172 | Quality Care At Home | Adult Companion | 5226 Whetstone Rd, North Chesterfield, VA 23234-4324 | 2019-11-07 |
| 1174165963 | Aracely Maldonado | Adult Companion | 3134 Eagle Talon St, Woodbridge, VA 22191-6509 | 2019-10-13 |
| 1770133886 | Gloria R Frye | Adult Companion | 10918 Robious Rd, North Chesterfield, VA 23235-3763 | 2019-09-19 |
| 1972155893 | Tina Kilby | Adult Companion | 430 Delaware Ave Apt 316, Norfolk, VA 23508-2847 | 2019-07-11 |
| 1568025559 | Sierra Jaleika May | Adult Companion | 4732 Marty Blvd, North Chesterfield, VA 23234-4743 | 2019-04-16 |
| Find all providers with the same taxonomy | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
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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.