EDWARD TUBBERVILLE
NPI 1649030156
Student in an Organized Health Care Education/Training Program in Fredericksburg, VA

Q: What is Edward Tubberville's NPI number?

The NPI number for Edward Tubberville is 1649030156. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Q: What is Edward Tubberville's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 21, 2024PECOS Enrolled

1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401(540) 741-9200(540) 741-9201 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Edward Tubberville NPPES

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

EDWARD TUBBERVILLE (NPI 1649030156) is an individual student in an organized health care education/training program in Fredericksburg, Virginia and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649030156

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameEDWARD TUBBERVILLE

Location Address1001 SAM PERRY BLVDFredericksburg, VA 22401-4453

Mailing Address530 W New Hope Rd Apt C1Goldsboro, NC 27534-7586 · (321) 525-2741

Phone(540) 741-9200

Fax(540) 741-9201

Sole ProprietorNo

Enumeration DateMarch 21, 2024

Last NPPES UpdateMay 14, 2025

NPPES CertifiedMay 14, 2025

✔ NPI 1649030156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1001 SAM PERRY BLVD, Fredericksburg, VA 22401

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edward Tubberville is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

JUSTIN HAMWAY RACKLEY MD

Anesthesiology