MRS. IDA TRICE VACLAVIK (NPI# 1134408644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134408644 |
| Entity Type | Individual |
| Full Name | MRS. IDA TRICE VACLAVIK |
| Other Name | MISS IDA SAWYER TRICE |
| Credential | NP |
| Practice Address |
601 Watkins Centre Pkwy Suite 200 Midlothian VA 23114-0002 |
| Practice Telephone | 8045943130 |
| Practice Fax Number | 8044236517 |
| Mailing Telephone | 8045943130 |
| Mailing Fax Number | 8044236517 |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2015-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024172575 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN1008705 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | GROUP PTAN | C09633 | 01 |
| Street Address |
601 WATKINS CENTRE PKWY SUITE 200 |
| City | MIDLOTHIAN |
| State | VA |
| Zip Code | 23114-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407035629 | Misti H Wilson | Surgery | 601 Watkins Centre Pkwy, Suite 200, Midlothian, VA 23114-0002 | 2007-10-25 |
| 1235505439 | Sean O'laughlin | Nurse Practitioner | 601 Watkins Centre Pkwy, Midlothian, VA 23114-0002 | 2015-08-11 |
| 1942479803 | Eric Floranda | Psychiatry & Neurology | 601 Watkins Centre Pkwy, Suite 250, Midlothian, VA 23114-0002 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122162 | Jotava | In Home Supportive Care | 1607 Titanium Avenue, 202, Midlothian, VA 23114 | 2020-10-20 |
| 1104393735 | Shelley Hurwitz | Occupational Therapist | 13800 Bon Secours Drive, Midlothian, VA 23114 | 2018-11-01 |
| 1316412182 | Snehal Manmeet Mahajan | Physical Therapist | 13800 Bon Secours Dr., Midlothian, VA 23114 | 2018-10-09 |
| 1154814796 | Bon Secours St Francis Medical Center Inc. | Clinic/Center | 13700 St Francis Blvd Ste 105, Midlothian, VA 23114 | 2018-06-08 |
| 1023516630 | Leah Reed | Occupational Therapist | 13800 Bon Secours Dr, Midlothian, VA 23114 | 2018-01-29 |
| 1689122012 | Momentum Counseling and Wellness LLC | Social Worker | 431 Walton Park Road, Midlothian, VA 23114 | 2016-09-14 |
| 1750765996 | Arlene Roper | Physical Therapy Assistant | 1700 Redbourne Ct, Apt 101, Midlothian, VA 23114 | 2015-07-17 |
| 1518353937 | Tamaika Floy | Podiatrist | 611 Watkins Centre Pkwy Ste 170, Midlothian, VA 23114 | 2015-04-13 |
| 1760790489 | Markita Wolf | Psychologist | 831 Grove Rd Ste C, Midlothian, VA 23114 | 2010-09-15 |
| 1306153119 | Jacinda Beth Chaisson | Physical Therapist | 13700 St. Francis Blvd., Suite 103, Midlothian, VA 23114 | 2010-09-01 |
| Find all providers in zip 23114 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799917 | Darnesha Shaunte Clanton | Nurse Practitioner | 401 Rockaway Dr, Midlothian, TX 76065-1199 | 2020-08-03 |
| 1740816685 | Anjalyse Maria Valenti | Nurse Practitioner | 542 Glenpark Ln, Midlothian, VA 23114-3067 | 2020-03-22 |
| 1861027419 | Mussie Futwi Mebrahtu | Nurse Practitioner | 214 Canterbury Ct, Midlothian, TX 76065-1417 | 2020-03-04 |
| 1457996167 | Elizabeth Murray | Nurse Practitioner | 1230 Alverser Dr Ste 104, Midlothian, VA 23113-2653 | 2019-11-18 |
| 1487214508 | Genevieve R. Matulin | Nurse Practitioner | 14319 Jeffries Pl, Midlothian, VA 23114-4359 | 2019-06-20 |
| 1780243329 | Brandi Hartsfield | Nurse Practitioner | 531 Totten Dr, Midlothian, VA 23113-3440 | 2019-06-07 |
| 1023675741 | Aisha Tate-odom | Nurse Practitioner | 14506 Spaulding Ave, Midlothian, IL 60445-3020 | 2019-05-29 |
| 1659861961 | Shaquita I. Alexander | Nurse Practitioner | 6204 Crowne Creek Dr, Midlothian, VA 23112-8315 | 2018-05-11 |
| 1245751874 | Kristyn Janine Childress | Nurse Practitioner | 14500 Needham Market Rd, Midlothian, VA 23112-1683 | 2017-07-05 |
| 1124567581 | Crystal Mann | Nurse Practitioner | 12000 Old Bailey Bridge Rd, Midlothian, VA 23112-3120 | 2017-02-18 |
| Find all providers in MIDLOTHIAN | ||||
| City | MIDLOTHIAN |
| Zip Code | 23114 |
Please comment or provide details below to improve the information on MRS. IDA TRICE VACLAVIK.
| 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.