JUSTIN R MIZE (NPI# 1104152479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104152479 |
| Entity Type | Individual |
| Full Name | JUSTIN R MIZE |
| Credential | PA |
| Practice Address |
4092 Foxwood Dr Suite 101 Virginia Beach VA 23462-5225 |
| Mailing Address |
Po Box 7549 Portsmouth VA 23707-0549 |
| Practice Telephone | 7574674200 |
| Practice Fax Number | 7576860541 |
| Mailing Telephone | 7576863515 |
| Mailing Fax Number | 7576860541 |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2010-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110003168 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4092 FOXWOOD DR SUITE 101 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-5225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700884343 | Joseph Scott Welch | Emergency Medicine | 4092 Foxwood Dr, Ste 101, Virginia Beach, VA 23462-5225 | 2005-07-08 |
| 1548735392 | Heather A Lustig | Physician Assistant | 4092 Foxwood Dr, Virginia Beach, VA 23462-5225 | 2018-10-09 |
| 1679066070 | Kendell Nicole Cobb | Physician Assistant | 4092 Foxwood Dr, Virginia Beach, VA 23462-5225 | 2018-06-11 |
| 1972002806 | Destiny Woods Houchin | Emergency Medicine | 4092 Foxwood Dr, Virginia Beach, VA 23462 | 2018-02-06 |
| 1417306317 | Kathryn Sidrow | Physician Assistant | 4092 Foxwood Dr, Suite 101, Virginia Beach, VA 23462-5225 | 2016-06-10 |
| 1295184737 | Liana Michelle Johnson | Physician Assistant | 4092 Foxwood Dr, Virginia Beach, VA 23462-5225 | 2016-06-06 |
| 1770937104 | Jacob Lunsford | Physician Assistant | 4092 Foxwood Dr, Suite 101, Virginia Beach, VA 23462-5225 | 2016-04-22 |
| 1962800649 | Stacey Alena Moody | Physician Assistant | 4092 Foxwood Dr, Suite 101, Virginia Beach, VA 23462-5225 | 2014-12-12 |
| 1114332020 | Victoria M Evelyn | Physician Assistant | 4092 Foxwood Dr, Virginia Beach, VA 23462-5225 | 2014-06-30 |
| 1568890473 | James L Thompson | Physician Assistant | 4092 Foxwood Dr, Ste 101, Virginia Beach, VA 23462-5225 | 2013-10-31 |
| Find all providers in the same location | ||||
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972011609 | Alexis A M Higgins | Physician Assistant | 1168 First Colonial Rd Ste 300, Virginia Beach, VA 23454-2444 | 2018-01-16 |
| 1720506207 | Brad Rivera | Physician Assistant | 1090 Farrar St, Virginia Beach, VA 23451-5808 | 2017-09-05 |
| 1386199016 | Zachary Kaplan | Physician Assistant | 2859 Virginia Beach Blvd Ste 100, Virginia Beach, VA 23452-7613 | 2016-08-23 |
| 1326434747 | Catharine White Cartwright | Physician Assistant | 2501 James Madison Blvd, Virginia Beach, VA 23456 | 2015-04-13 |
| 1407097215 | Steven Brian Bennett | Physician Assistant | 472 Polaris St Bldg 586, Virginia Beach, VA 23461-1935 | 2009-03-09 |
| 1366682056 | Jessica Lea Simpkins | Physician Assistant | 4092 Foxwood Drive, Suite 101, Virginia Beach, VA 23462 | 2009-02-20 |
| 1578602017 | Mary Jo Dougherty | Physician Assistant | 1133 First Colonial Rd, Virginia Beach, VA 23454-2402 | 2007-02-05 |
| 1689770323 | Catherine F Walgren | Physician Assistant | 4536 Bonney Rd, Virginia Beach, VA 23462-3818 | 2006-09-16 |
| 1164487393 | Mindy Ann Siyufy | Physician Assistant | 968 First Colonial Rd, Suite101, Virginia Beach, VA 23454-3171 | 2006-04-19 |
| 1912971201 | Richard Ryan Crooks | Physician Assistant | 5486 Indian River Rd, Virginia Beach, VA 23464-5365 | 2006-02-14 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
Please comment or provide details below to improve the information on JUSTIN R MIZE.
| 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.