JUDY GOURLEY (NPI# 1740686047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740686047 |
| Entity Type | Individual |
| Full Name | JUDY GOURLEY |
| Practice Address |
2204 Wilborn Ave South Boston VA 24592-1645 |
| Practice Telephone | 4345173579 |
| Mailing Telephone | 4345173579 |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 613615 | VA | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | LOOO602 | NC | Dietary & Nutritional Service Providers |
| Street Address |
2204 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592-1645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668842 | Halifax Regional Hospital, Inc. | General Acute Care Hospital | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2005-06-02 |
| 1871058008 | Angeline Marie Davis | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2019-02-01 |
| 1063931897 | Jon Michael Hughes | Nurse Practitioner | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-13 |
| 1265950646 | Mara Olivia Fiorio | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-06 |
| 1942745526 | Alisyn L. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1255876835 | Andrew D. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1942743398 | Melaku Akele | Physical Therapist | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-12-01 |
| 1740730316 | Emily Silsby | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-10-07 |
| 1023567153 | Mulbriar Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-09-30 |
| 1205381621 | Banister River Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124421276 | Nutritious Navigation | Dietitian, Registered | 99 M St, #5, South Boston, MA 02127-3193 | 2014-10-03 |
| 1912080086 | Patricia E. Heanue | Dietitian, Registered | 94 G St, South Boston, MA 02127-2977 | 2006-10-23 |
| 1265950646 | Mara Olivia Fiorio | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-06 |
| 1740730316 | Emily Silsby | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-10-07 |
| 1184714164 | Lisa Caudle | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891876 | Margaret Rawls | Dietitian, Registered | 4303 Smithdeal Ave, Richmond, VA 23225-3320 | 2020-11-05 |
| 1558968875 | Veronica Winkler | Dietitian, Registered | 208 Birch St Ne, Leesburg, VA 20176-4524 | 2020-10-08 |
| 1235736364 | Shirin Pourafshar | Dietitian, Registered | 966 Belvedere Blvd, Charlottesville, VA 22901-3202 | 2020-10-01 |
| 1326645557 | Erin Elizabeth Redgrave | Dietitian, Registered | 1055 Old Fox Trail Ln, Crozet, VA 22932-3141 | 2020-10-01 |
| 1528675204 | Lyndel Rose Schuster | Dietitian, Registered | 3104 Park Ave, Richmond, VA 23221-1610 | 2020-09-28 |
| 1174139406 | Nicole Evangelista | Dietitian, Registered | 815 18th St S Apt 601, Arlington, VA 22202-2633 | 2020-09-22 |
| 1366058612 | Karen Perez Via | Dietitian, Registered | 3580 Joseph Siewick Dr Ste 204, Fairfax, VA 22033-1764 | 2020-09-22 |
| 1447866926 | Rita Ann Eusanio | Dietitian, Registered | 5903 Mount Eagle Dr Apt 1409, Alexandria, VA 22303-2532 | 2020-09-19 |
| 1154935179 | Eryn David | Dietitian, Registered | 700 Jenny Ann Ct, Herndon, VA 20170-3152 | 2020-09-08 |
| 1043823420 | Grace Lange Kopf | Dietitian, Registered | 6953 Fieldwood Rd, Chester, VA 23831-3832 | 2020-08-26 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
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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.