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MASONIC HOME OF VIRGINIA
NPI 1558677658
Nursing Facility/Intermediate Care Facility in Richmond, VA

Active since August 26, 2010CLIA 49D0903855 · Waiver
4101 NINE MILE RD, RICHMOND, VA 23223(804) 222-1694(804) 226-4567 Get Directions Write a Review

NPPES record last updated: August 26, 2010. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Masonic Home Of Virginia NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MASONIC HOME OF VIRGINIA (NPI 1558677658) is a healthcare organization registered as a nursing facility/intermediate care facility in Richmond, Virginia and active in the NPI registry since August 2010. The organization holds a CLIA Waiver certificate valid through July 30, 2027 and lists James D Cole, Ceo, as its authorized official.

NPPES Registry Identity

NPI1558677658
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameMASONIC HOME OF VIRGINIA
Location Address4101 NINE MILE RDRichmond, VA 23223-4956
Mailing Address4101 Nine Mile RdRichmond, VA 23223-4956 · (804) 222-1694 · Fax (804) 226-4567
Phone(804) 222-1694
Fax(804) 226-4567
Organization SubpartNo
Authorized OfficialJames D ColeCeo · (804) 222-1694
Enumeration DateAugust 26, 2010
✔ NPI 1558677658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in VA · NH2628
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
4101 NINE MILE RD, Richmond, VA 23223
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D0903855

Masonic Home Of Virginia · Richmond, VA
Active · expires Jul 30, 2027
CLIA Number49D0903855
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorTommy L. Jones
Laboratory Phone(804) 222-1694
Laboratory LocationMasonic Home Of Virginia4101 Nine Mile Road, Richmond, VA 23223
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY YOUNG LIPSCOMBE PT
Physical Therapist
4101 NINE MILE RD
RICHMOND, VA 23223
Henrico County (804) 222-1694
MS. MELANIE L. BAILEY M.ED
Speech-Language Pathologist
4101 NINE MILE RD
RICHMOND, VA 23223
Henrico County (804) 222-1694
MRS. JACLYN S MONTEIRO OTR
Occupational Therapist
4101 NINE MILE RD
RICHMOND, VA 23223
Henrico County (804) 222-1694

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Masonic Home Of Virginia's NPI number?

The NPI number for Masonic Home Of Virginia is 1558677658. It was assigned to this organization in the NPPES registry on August 26, 2010.

Where is Masonic Home Of Virginia located?

Masonic Home Of Virginia is located at 4101 Nine Mile Rd, Richmond, VA 23223. The listed phone number is (804) 222-1694.

What is Masonic Home Of Virginia's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Masonic Home Of Virginia hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D0903855) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Masonic Home Of Virginia was last updated on August 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.