Provider Demographics
NPI:1912919481
Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Entity Type:Organization
Organization Name:CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-668-8565
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-7017
Mailing Address - Fax:757-668-8646
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7017
Practice Address - Fax:757-668-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 261QE0700X, 261QU0200X, 291U00000X
VAH1843282N00000X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No282N00000XHospitalsGeneral Acute Care Hospital
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004900961Medicaid
VA236297OtherOPTIMUM CHOICE
VA116838OtherANTHEM TRANSPORT
VA000082OtherANTHEM BC BS
VA169288OtherANTHEM REFERENCE LAB
VA236297OtherMDIPA
VA4900961OtherVIRGINIA PREMIER
DE0000620505Medicaid
VA009013857Medicaid
VA184601OtherANTHEM OYSTER POINT
VA236297OtherALLIANCE
WV0175123000Medicaid
VA0096618OtherAETNA
NC4903301Medicaid
VA004930177Medicaid
NC001AYOtherSTATE OF NC TEACHERS & ST
VA236297OtherOPTIMUM CHOICE
VA=========OtherOPTIMA/SENTARA
VA=========OtherTRICARE (HEALTHNET)
VA169288OtherANTHEM REFERENCE LAB
VA184601OtherANTHEM OYSTER POINT