Healthcare Provider Details

I. General information

NPI: 1205945904
Provider Name (Legal Business Name): PATRIOTS COLONY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 PATRIOTS COLONY DR
WILLIAMSBURG VA
23188-1396
US

IV. Provider business mailing address

608 DENBIGH BLVD STE 602
NEWPORT NEWS VA
23608-4442
US

V. Phone/Fax

Practice location:
  • Phone: 757-220-9000
  • Fax: 757-220-1681
Mailing address:
  • Phone: 757-875-2023
  • Fax: 757-875-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH2652
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberNH2652
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH2652
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberNH2652
License Number StateVA

VIII. Authorized Official

Name: MR. WALTER W AUSTIN
Title or Position: CFO
Credential:
Phone: 757-875-7846