1730400607 NPI number — DANIELLE R. HINKEY PT, DPT, AIB-VR

Table of content: DANIELLE R. HINKEY PT, DPT, AIB-VR (NPI 1730400607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730400607 NPI number — DANIELLE R. HINKEY PT, DPT, AIB-VR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINKEY
Provider First Name:
DANIELLE
Provider Middle Name:
R.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, AIB-VR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROWLAND
Provider Other First Name:
DANIELLE
Provider Other Middle Name:
G.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT, AIB-VR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730400607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 69030
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-9030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-873-2302
Provider Business Mailing Address Fax Number:
757-873-2306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2007 MEADE PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUFFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23434-4259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-539-6300
Provider Business Practice Location Address Fax Number:
757-539-0704
Provider Enumeration Date:
06/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  2305206471 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 496633 . This is a "MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 004979796 . This is a "VIRGINIA MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1730400607 . This is a "MEDICAID QMB" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 116714300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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