Healthcare Provider Details

I. General information

NPI: 1255206439
Provider Name (Legal Business Name): JOEY BETTS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 JAMISON ST NE
WASHINGTON DC
20018-4453
US

IV. Provider business mailing address

551 SCHAEFER AVE
CHESAPEAKE VA
23321-2729
US

V. Phone/Fax

Practice location:
  • Phone: 904-982-6109
  • Fax:
Mailing address:
  • Phone: 904-982-6109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: