| |
2207 Executive Dr Ste B Hampton VA 23666-2478 | |
(757) 826-1600 | |
(757) 826-0160 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2207 Executive Dr, Hampton, Virginia |
Authorized Official Name and Position | Debra Foster Chinnery (OWNER) |
Authorized Official Contact | 7578260514 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2207 Executive Dr Ste B Hampton VA 23666-2478 Ph: (757) 826-1600 | 2207 Executive Dr Ste B Hampton VA 23666-2478 Ph: (757) 826-1600 |
NPI Number | 1053659714 |
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Provider Enumeration Date | 01/30/2013 |
Last Update Date | 02/13/2017 |
Medicare PECOS PAC ID | 7618111667 |
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Medicare Enrollment ID | O20130913000392 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053659714 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 0017000454 (Virginia) | Primary |
Provider Name | Debra Chinnery |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225127582 PECOS PAC ID: 6305903600 Enrollment ID: I20090331000198 |
Mbs Child Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 S Second St, Hampton, VA 23664 Phone: 767-902-6108 | |
Gastroenterology Specialist Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Marcella Rd, Suite A, Hampton, VA 23666 Phone: 757-826-6539 | |
Southampton Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2112 Executive Dr, Hampton, VA 23666 Phone: 757-723-0252 Fax: 866-837-2972 | |