OrganizationActive
Federal Bureau Prisons, Fcc Petersburg
NPI 1700154978 · Federally Qualified Health Center (FQHC) · Petersburg, VA
Provider details
- NPI number
- 1700154978
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Abdelouahab Benmansour, Hsa(804) 504-7200
- License
- MD052885L (PA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1060 River Rd
Petersburg, VA 23801-1398
Phone: (804) 504-7200
Fax: (804) 504-7225
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 90026
Petersburg, VA 23804-9000
Registry dates
- Enumerated
- 2011-12-02
- Last updated
- 2022-04-22
- Certified
- 2022-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.