1952270662 NPI number — MOMENTUM RECOVERY VIRGINIA LLC

Table of content: JIMMIE DEAN DOBBS CMII (NPI 1659041556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952270662 NPI number — MOMENTUM RECOVERY VIRGINIA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOMENTUM RECOVERY VIRGINIA LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952270662
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1935 S HURSTBOURNE PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40220-1645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-666-4838
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 CHIP MILL ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTWOOD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-666-4838
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2025

Additional Information

Authorized Official

Authorized Official Last Name:
BOGGS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
AUTHORIZED AGENT
Authorized Official Telephone Number:
304-972-8383

Provider Taxonomy Codes

  • Taxonomy code: 324500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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