SENTARA HALIFAX REGIONAL HOSPITAL - NPI 1992724033 - General Acute Care Hospital in South Boston, VA

Q: What is the provider's specialty?

The provider's specialty is General Acute Care Hospital with taxonomy code 282N00000X.

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About Sentara Halifax Regional Hospital NPPES

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

SENTARA HALIFAX REGIONAL HOSPITAL (NPI 1992724033) is a healthcare organization registered as a general acute care hospital in South Boston, Virginia and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Stephanie W Elliott, Coordinator Third Party Payers, as its authorized official.

NPPES Registry Identity

NPI1992724033

Entity TypeOrganization

Primary Taxonomy282N00000X

Legal Business NameHALIFAX REGIONAL HOSPITAL

Location Address2204 WILBORN AVESouth Boston, VA 24592-1645

Mailing Address2204 Wilborn AveSouth Boston, VA 24592-1645 · (434) 517-3100 · Fax (434) 575-0377

Phone(434) 517-3100

Fax(434) 575-0377

Organization SubpartNo

Authorized OfficialStephanie W ElliottCoordinator Third Party Payers · (434) 517-3156

Enumeration DateJuly 19, 2006

Last NPPES UpdateApril 9, 2015

✔ NPI 1992724033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral Acute Care HospitalHospitals

Taxonomy Code282N00000X

License✔ Licensed in VA · H1853

Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

Also ListedSpecialist/Technologist, PathologyTaxonomy 246Q00000X · License H1853 (VA)

Also ListedTechnician, CardiologyTaxonomy 246W00000X · License H1853 (VA)

2204 WILBORN AVE, South Boston, VA 24592

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Other Names 1

Doing Business AsSentara Halifax Regional Hospital

Other Identifiers 17

Medicaid005810922VA

Medicaid005831300VA

Medicaid006017738VA

Medicaid006087701VA

Medicaid007306628VA

Medicaid010053871VA

Medicaid010263867VA

Medicaid006072097VA

Medicaid006086675VA

Medicaid010110041VA

Medicaid005802334VA

Medicaid005828902VA

Medicaid006081011VA

Medicaid006604510VA

Medicaid005875251VA

Medicaid006041736VA

Medicaid006089526VA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 49D0233332

Sentara Halifax Regional Hospital Lab · South Boston, VA

Active · expires Feb 27, 2027

CLIA Number49D0233332

Laboratory TypeHospital

Certificate Effective DateFebruary 28, 2025

Certificate Expiration DateFebruary 27, 2027

Laboratory DirectorDr. John M. Salmon

Laboratory Phone(804) 575-3231

Laboratory LocationSentara Halifax Regional Hospital Lab2204 Wilborn Ave Attn Ed Agricola, South Boston, VA 24592

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 49D2176341

Sentara Halifax Regional Hospital-Behavioral Health Department · South Boston, VA

Active · expires Dec 11, 2027

CLIA Number49D2176341

Laboratory TypeAncillary Testing Site In Health Care Center

Certificate Effective DateDecember 12, 2025

Certificate Expiration DateDecember 11, 2027

Laboratory DirectorGregory Weiss

Laboratory Phone(434) 517-3885

Laboratory LocationSentara Halifax Regional Hospital-Behavioral Health Department504 Wilborn Avenue, South Boston, VA 24592

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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.

HALIFAX REGIONAL HOSPITAL, INC

Skilled Nursing Facility