ENVOY OF WOODBRIDGE LLC NPI 1205089240

NPI Information

  • NPI: 1205089240
  • Provider Name: ENVOY OF WOODBRIDGE, LLC
  • Classification: Skilled Nursing Facility - 314000000X
  • Entity Type: Organization
  • CLIA Number: 49D0679545
  • Address: 14906 JEFFERSON DAVIS HWY
    WOODBRIDGE, VA
    ZIP 22191
  • Phone: (703) 491-6167

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NPI Details

ENVOY OF WOODBRIDGE, LLC is a skilled nursing facility in Woodbridge, VA. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. ENVOY OF WOODBRIDGE, LLC NPI is 1205089240. The provider is registered as an organization entity type.

The provider's business location address is:

14906 JEFFERSON DAVIS HWY
WOODBRIDGE, VA
ZIP 22191-016
Phone: (703) 491-6167

The provider's authorized official is Kenneth Ussery .
The authorized official title is Vp and has the following contact phone number (407) 571-1550.

The CLIA number assigned to this NPI record is 49D0679545 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2008 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1314000000XSkilled Nursing FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11205089240MEDICAIDVIRGINIA
24953614MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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