Provider Demographics
NPI:1265560262
Name:RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA
Entity type:Organization
Organization Name:RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-243-9308
Mailing Address - Street 1:PO BOX 800778
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0778
Mailing Address - Country:US
Mailing Address - Phone:434-924-8344
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-8344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECTOR AND VISITORS OF THE UNIVERSITY OF VIRGINIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008859604Medicaid
VAC06859Medicare PIN
VA008859604Medicaid
VAC06861Medicare PIN
VAC07038Medicare PIN
VAC06862Medicare PIN
VAC06940Medicare PIN
VAC02802Medicare PIN
VAC06857Medicare PIN
VAC06863Medicare PIN
VAC06860Medicare PIN