MH 102, PC (NPI# 1669006706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669006706 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Practice Address |
838 Old George Washington Hwy N Ste T&u Chesapeake VA 23323-2209 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 7573897631 |
| 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 Washington Shoppes | 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 |
| 1588298624 | Mh 102, PC | Nurse Practitioner | 817 Botetourt Ct Ste 106, Chesapeake, VA 23320-4886 | 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
838 OLD GEORGE WASHINGTON HWY N STE T&U |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23323-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578914081 | Suzanne Sisson Smith | Nurse Practitioner | 838 Old George Washington Hwy N Ste T&u, Chesapeake, VA 23323-2209 | 2016-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417413444 | Tiwana Lynn Jordan | Driver | 2139 Chesterfield Loop, Chesapeake, VA 23323 | 2019-02-14 |
| 1578040051 | Utopia C&c LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1212 Excalibur Ct, Chesapeake, VA 23323 | 2018-07-26 |
| 1851755003 | Behavior Analytic Associates | Behavioral Analyst | 522 Atamasco St, Chesapeake, VA 23323 | 2016-04-13 |
| 1134297344 | D Machelle Kerr | Chiropractor | 164 S George Washington Hwy, Chesapeake, VA 23323 | 2006-12-04 |
| 1053403816 | Cathy L. Rearden | Dentist | 2346 Cedar Road, Chesapeake, VA 23323 | 2006-09-29 |
| 1306857909 | Jose Dabu Leoncio | Family Medicine | 1061 Ne Washington Hwy, Chesapeake, VA 23323 | 2006-08-10 |
| 1952370702 | George Washington Health & Rehab of Chesapeake, Inc | Skilled Nursing Facility | 1017 George Washington Hwy., Chesapeake, VA 23323 | 2006-03-15 |
| 1528040474 | Dr George E Berryman Dds | Dentist | 838 Old George Washington Hwy, Suite C, Chesapeake, VA 23323 | 2005-11-16 |
| 1891216933 | Black Top Town Car Service LLC | Non-emergency Medical Transport (VAN) | 410 Millhouse Ct, Chesapeake, VA 23323-0882 | 2017-06-29 |
| 1609048651 | Hope Offord-powell | Speech-Language Pathologist | 404 Undershot Ct, Chesapeake, VA 23323-0883 | 2008-03-31 |
| Find all providers in zip 23323 | ||||
| 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 |
| 1588298624 | Mh 102, PC | Nurse Practitioner | 817 Botetourt Ct Ste 106, Chesapeake, VA 23320-4886 | 2020-02-27 |
| 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 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23323 |
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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.