HALIFAX REGIONAL HOSPITAL, INC (NPI# 1891786570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891786570 |
| Entity Type | Organization |
| Organization Name | HALIFAX REGIONAL HOSPITAL, INC |
| Practice Address |
2204 Wilborn Ave South Boston VA 24592-1645 |
| Practice Telephone | 4345173100 |
| Practice Fax Number | 4345173819 |
| Mailing Telephone | 4345173100 |
| Mailing Fax Number | 4345173819 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | MRS. STEPHANIE WOMACK ELLIOTT (COORDINATOR THIRD PARTY PAYERS) |
| Authorized Official Telephone | 4345173156 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | H1853 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM PROVIDER # | 000054 | 01 |
| VA | 8536228 | 05 | |
| VA | 004952294 | 05 | |
| VA | 004900138 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841809241 | Halifax Regional Hospital, Inc | Clinic/Center | 2100 Wilborn Ave, South Boston, VA 24592-1628 | 2020-07-31 |
| 1023627486 | Halifax Regional Hospital, Inc | Clinic/Center | 101 Aubreys Loop, South Boston, VA 24592-5054 | 2020-07-30 |
| 1033728803 | Halifax Regional Hospital, Inc | Clinic/Center | 2206 Wilborn Ave, Medical Office Building #1, South Boston, VA 24592 | 2020-07-28 |
| 1154930824 | Halifax Regional Hospital, Inc | Clinic/Center | 115 College St, Clarksville, VA 23927-9125 | 2020-07-28 |
| 1861001539 | Halifax Regional Hospital, Inc | Clinic/Center | 946 N Main St, Chase City, VA 23924-1139 | 2020-07-28 |
| 1851900534 | Halifax Regional Hospital, Inc | Clinic/Center | 15210 L P Bailey Memorial Hwy, Nathalie, VA 24577-3304 | 2020-07-28 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821195165 | Marian Manor, for The Aged and Infirm, Inc. | Skilled Nursing Facility | 130 Dorchester Street, South Boston, MA 02127-2642 | 2006-09-20 |
| 1649215252 | Berry Hill Nursing Home, Inc. | Skilled Nursing Facility | 621 Berry Hill Rd, South Boston, VA 24592-2207 | 2006-06-18 |
| 1740277359 | South Boston Manor, LLC | Skilled Nursing Facility | 406 Oak Ln, South Boston, VA 24592-1634 | 2005-09-29 |
| 1528065026 | Halifax Regional Long Term Care, Inc | Skilled Nursing Facility | 103 Rosehill Dr, South Boston, VA 24592-4843 | 2005-06-30 |
| 1730798869 | South Boston Health & Rehab Center, LLC | Skilled Nursing Facility | 103 Rosehill Dr, South Boston, VA 24592-4843 | 2020-07-24 |
| 1528584638 | 804 East 7th Street Operator LLC | Skilled Nursing Facility | 804 E 7th St, South Boston, MA 02127-4346 | 2017-08-21 |
| 1104093525 | Emily Elizabeth Martin | Skilled Nursing Facility | 804 E 7th St, South Boston, MA 02127-4346 | 2008-05-14 |
| 1992812929 | Harborlights Nursing, L.L.C. | Skilled Nursing Facility | 804 E 7th St, South Boston, MA 02127-4346 | 2006-08-24 |
| 1740269893 | South Boston Nursing LLC | Skilled Nursing Facility | 804 E 7th St, South Boston, MA 02127-4346 | 2006-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760015119 | Mikaylah Lang | Skilled Nursing Facility | 4505 Georgewashington Hwy, Portsmouth, VA 23702 | 2020-02-13 |
| 1134760432 | Valley Operator LLC | Skilled Nursing Facility | 940 E Lee Hwy, Chilhowie, VA 24319-3237 | 2019-10-08 |
| 1871134171 | Westport Operator LLC | Skilled Nursing Facility | 7300 Forest Ave, Richmond, VA 23226-3735 | 2019-10-08 |
| 1437790730 | Hopewell Operator LLC | Skilled Nursing Facility | 905 Cousins Ave, Hopewell, VA 23860-6507 | 2019-10-08 |
| 1013478411 | Blue Ridge Snf Operations LLC | Skilled Nursing Facility | 105 Landmark Dr, Stuart, VA 24171-9401 | 2019-03-28 |
| 1265924260 | Nassawadox Life Care, LLC | Skilled Nursing Facility | 9468 Hospital Road, Nassawadox, VA 23413-0176 | 2018-06-05 |
| 1518459593 | Big Stone Gap Life Care, LLC | Skilled Nursing Facility | 2045 Valley View Dr, Big Stone Gap, VA 24219-3319 | 2018-06-05 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1033660360 | Nathan Ian Dalleave | Skilled Nursing Facility | 1243 Lanier Rd, Martinsville, VA 24112-5211 | 2016-10-21 |
| 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.