| Capital Area Health Network | |
|
2809 North Ave Richmond VA 23222-3647 | |
| (804) 780-0840 | |
| (804) 780-0862 |
| Full Name | Capital Area Health Network |
|---|---|
| Speciality | Clinic/Center |
| Location | 2809 North Ave, Richmond, Virginia |
| Authorized Official Name and Position | Tracy Causey (CEO) |
| Authorized Official Contact | 8047800840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Area Health Network 2809 North Ave Richmond VA 23222-3647 Ph: (804) 780-0840 | Capital Area Health Network 2809 North Ave Richmond VA 23222-3647 Ph: (804) 780-0840 |
| NPI Number | 1295707966 |
|---|---|
| Provider Enumeration Date | 02/06/2006 |
| Last Update Date | 08/16/2023 |
| Medicare PECOS PAC ID | 9638064850 |
|---|---|
| Medicare Enrollment ID | O20040217000877 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295707966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Torino R Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225149750 PECOS PAC ID: 4385625300 Enrollment ID: I20040526000723 |
| Provider Name | Malinda A Brooks Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598777997 PECOS PAC ID: 0749256279 Enrollment ID: I20040907000928 |
| Provider Name | Dianne L Reynolds Cane |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326096611 PECOS PAC ID: 1658479266 Enrollment ID: I20070605000635 |
| Provider Name | Leon Junius Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174535009 PECOS PAC ID: 0941367635 Enrollment ID: I20090325000056 |
| Provider Name | Sultan A Lakhani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114975471 PECOS PAC ID: 5395887103 Enrollment ID: I20100116000085 |
| Provider Name | Sarah E Deboer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578707410 PECOS PAC ID: 4082860648 Enrollment ID: I20120814000418 |
| Provider Name | Dayna M Vango |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336313253 PECOS PAC ID: 5698087021 Enrollment ID: I20150629000080 |
| Provider Name | Mara J Dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700268745 PECOS PAC ID: 4688956311 Enrollment ID: I20170112003010 |
| Provider Name | Nicole Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538604210 PECOS PAC ID: 5698050581 Enrollment ID: I20170315001649 |
| Provider Name | James Jenkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023002177 PECOS PAC ID: 0547169500 Enrollment ID: I20200413002340 |
| Provider Name | Amy Starlite Huddle-thomason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164780821 PECOS PAC ID: 4688004393 Enrollment ID: I20200421001305 |
| Provider Name | Catherine Goodall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215356126 PECOS PAC ID: 0345462826 Enrollment ID: I20201104001767 |
| Provider Name | Angela Gail Biggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790449023 PECOS PAC ID: 5193111805 Enrollment ID: I20220406000735 |
| Provider Name | Rita Denise Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225563240 PECOS PAC ID: 9638561590 Enrollment ID: I20220502000994 |
| Provider Name | Christie Wetzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689622722 PECOS PAC ID: 1355375049 Enrollment ID: I20220503000321 |
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