Provider Type Icon

DR. CALVIN A. FUNKHOUSER DO NPI 1417914789


NPI Information

NPI: 1417914789
Provider Name: DR. CALVIN A. FUNKHOUSER, DO
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
500 J CLYDE MORRIS BLVD DEPT OF
NEWPORT NEWS, VA
ZIP 23601
Phone: (757) 612-7200
Get Directions

DR. Calvin A. Funkhouser, DO is a student in an organized health care education training program in Newport News, VA. The provider is 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. DR. Calvin A. Funkhouser, DO NPI is 1417914789. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 J CLYDE MORRIS BLVD DEPT OF
NEWPORT NEWS, VA
ZIP 23601-929
Phone: (757) 612-7200
Fax: (757) 594-3184

The NPI 1417914789 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/28/2006 and was last updated on 7/8/2021.


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
1363A00000XPhysician Assistant0110001910VIRGINIANo
2390200000XStudent in an Organized Health Care Education/Training Program0116035964VIRGINIAYes

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
1010117801MEDICAIDVIRGINIA
2P00263494OTHERVIRGINIARAILROAD MEDICARE

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.