| Portsmouth Community Health Center, Inc. | |
|
1541 High St Portsmouth VA 23704 | |
| (757) 393-6363 | |
| (757) 397-0047 |
| Full Name | Portsmouth Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1541 High St, Portsmouth, Virginia |
| Authorized Official Name and Position | Barbara Willis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7573970042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portsmouth Community Health Center, Inc. 1541 High St Portsmouth VA 23704 Ph: (757) 393-6363 | Portsmouth Community Health Center, Inc. 1541 High St Portsmouth VA 23704 Ph: (757) 393-6363 |
| NPI Number | 1134199193 |
|---|---|
| Provider Enumeration Date | 01/24/2006 |
| Last Update Date | 02/23/2023 |
| Medicare PECOS PAC ID | 1052301835 |
|---|---|
| Medicare Enrollment ID | O20040513001366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134199193 | NPI | - | NPPES |
| 007600267 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Thedia Jones Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013015080 PECOS PAC ID: 6305942251 Enrollment ID: I20070509000507 |
| Provider Name | Angela Ferebee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083640726 PECOS PAC ID: 6406981075 Enrollment ID: I20100322000313 |
| Provider Name | Michael Spruiell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669411963 PECOS PAC ID: 1355475377 Enrollment ID: I20120518000024 |
| Provider Name | Vladimir Markovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710266796 PECOS PAC ID: 0941523112 Enrollment ID: I20141218001589 |
| Provider Name | Mattie Lynn Aekins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992169056 PECOS PAC ID: 9032400106 Enrollment ID: I20160621000241 |
| Provider Name | Meno Mazemda Kouakeu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710338546 PECOS PAC ID: 0749576676 Enrollment ID: I20161101002670 |
| Provider Name | Kathryn Langan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861998981 PECOS PAC ID: 5395091318 Enrollment ID: I20180705002335 |
| Provider Name | Margarita Maria Marmolejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760035810 PECOS PAC ID: 9032524764 Enrollment ID: I20210210002252 |
| Provider Name | Kevin Dewitt Jennings |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1669462941 PECOS PAC ID: 0345636478 Enrollment ID: I20220329002748 |
| Provider Name | Ahmad Rashad Clemmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780305276 PECOS PAC ID: 2567832256 Enrollment ID: I20221220002861 |
| Provider Name | Anthony Dewayne Quarles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366954570 PECOS PAC ID: 1355787433 Enrollment ID: I20240312000523 |
| Provider Name | Heather Marie Szeles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285402891 PECOS PAC ID: 8123466901 Enrollment ID: I20240329002792 |
Hampton Roads Hospitalist Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3636 High St, Portsmouth, VA 23707 Phone: 757-535-3696 Fax: 757-622-4585 | |
Olde Towne Medical Practice Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Goode Way Ste 103, Portsmouth, VA 23704 Phone: 757-399-0701 Fax: 757-399-3731 | |
Pediatric Health Partners,pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 South St, Portsmouth, VA 23707 Phone: 757-966-9873 Fax: 757-967-9547 | |
Olde Towne Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 North St, Portsmouth, VA 23704 Phone: 757-397-1246 Fax: 757-397-0089 | |
Hampton Roads Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Goode Way Ste 206, Portsmouth, VA 23704 Phone: 757-642-0240 | |
Joseph B Hollis Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1211 Rodman Ave, Portsmouth, VA 23707 Phone: 757-397-2493 Fax: 757-397-7189 |