MH 102, PC (NPI# 1588298624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588298624 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Practice Address |
817 Botetourt Ct Ste 106 Chesapeake VA 23320-4886 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 7573897300 |
| Mailing Telephone | 8028570400 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | BEVERLEY RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 8028570400 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | MH 102, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Chesapeake Knells Ridge | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 1457985590 | Mh 102, PC | Nurse Practitioner | 193 Tilley Dr, South Burlington, VT 05403-4440 | 2020-02-27 |
| 1831723964 | Mh 102, PC | Nurse Practitioner | 1932 Wynnton Rd, Columbus, GA 31999-0001 | 2020-02-27 |
| 1174157218 | Mh 102, PC | Nurse Practitioner | 813 E 68th St Ste B, Savannah, GA 31405-4710 | 2020-02-27 |
| 1457985509 | Mh 102, PC | Nurse Practitioner | 5204 Bernard Dr Ste 300a, Roanoke, VA 24018-4345 | 2020-02-27 |
| 1285105171 | Mh 102, PC | Nurse Practitioner | 2322 Blue Stone Hills Dr Ste 260, Harrisonburg, VA 22801-5403 | 2018-12-17 |
| 1811476286 | Mh 102, PC | Nurse Practitioner | 1020 Barrow Industrial Pkwy, Winder, GA 30680-3891 | 2018-08-07 |
| 1689177040 | Mh 102, PC | Nurse Practitioner | 98 Alexandria Pike Ste 52, Warrenton, VA 20186-2849 | 2018-03-13 |
| 1720599657 | Mh 102, PC | Nurse Practitioner | 864 Spring St Nw, Atlanta, GA 30308-1007 | 2017-10-18 |
| 1053754275 | Mh 102, PC | Non-Pharmacy Dispensing Site | 5650 Main St, C/o Vcs Health Center, Manchester Center, VT 05255-9711 | 2013-04-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
817 BOTETOURT CT STE 106 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23320-4886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1538624804 | Shaniqah Mcleod | Home Health | 217 Centerville Turnpike N, Chesapeake, VA 23320 | 2019-01-31 |
| 1942764113 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1400 Kempsville Rd, Virginia Beach, VA 23320 | 2019-01-22 |
| 1639647993 | Madison Vansavage Maben | Orthotist | 433 Network Sta, Chesapeake, VA 23320 | 2018-11-05 |
| 1568947356 | Kelly M Muchetti | Massage Therapist | 1421 C. Kempsville Rd., Chesapeake, VA 23320 | 2018-09-27 |
| 1235612912 | L&s Home Health Care, LLC. | Home Health | 1545 Cossways Blv, Chesepeake, VA 23320 | 2018-09-10 |
| 1154803500 | Latricia A Patterson | Home Health | 813-a Professional Pl Ste 107, Chesapeake, VA 23320 | 2018-09-02 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1831676105 | Lance Taylor | Technician | 1645 Crossways Blvd Ste 250, Chesapeake, VA 23320 | 2018-07-19 |
| 1023507688 | Sentoria Howell Harold | Social Worker | 920 Ventures Way Ste 4, Chesapeake, VA 23320 | 2018-05-08 |
| Find all providers in zip 23320 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790390938 | Premier Healthcare Service, LLC | Nurse Practitioner | 1015 Eden Way N Ste A, Chesapeake, VA 23320-2787 | 2020-09-14 |
| 1003450941 | Danielle Susan Cavallo-fat | Nurse Practitioner | 1008 Bowling Green Trl, Chesapeake, VA 23320-3144 | 2019-11-04 |
| 1952962060 | Ashley Leigh Riffe | Nurse Practitioner | 901 Buckingham Dr, Chesapeake, VA 23320-9339 | 2019-06-28 |
| 1023674645 | Shulounda Vontoure | Nurse Practitioner | 3211 Calisha Ct, Chesapeake, VA 23321-1598 | 2019-05-20 |
| 1457898728 | Crystal J Jones | Nurse Practitioner | 4333 Mooring Ct, Chesapeake, VA 23321-1982 | 2017-01-25 |
| 1386189918 | Karen Goodrich | Nurse Practitioner | 3701 Point Elizabeth Dr, Chesapeake, VA 23321-5754 | 2017-01-05 |
| 1003289562 | Lisa M Hills I | Nurse Practitioner | 4350 Taylor Road, Suite K, Chesapeake, VA 23321-5526 | 2015-11-05 |
| 1033522602 | Trisha Lynn O'meara | Nurse Practitioner | 747 Volvo Pkwy Ste 102, Chesapeake, VA 23320-1615 | 2014-06-11 |
| 1457617003 | Kathleen Meaghan Nelson | Nurse Practitioner | 1609 Whippoorwill Trce, Chesapeake, VA 23322-1275 | 2012-04-09 |
| 1821370321 | Kenanville Surgical Clinic | Nurse Practitioner | 109 Wimbledon Sq Ste C, Chesapeake, VA 23320-4945 | 2011-09-12 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23320 |
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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.