MONTICELLO PLASTIC AND RECONSTRUCTIVE SURGERY, PC (NPI# 1023429818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023429818 |
| Entity Type | Organization |
| Organization Name | MONTICELLO PLASTIC AND RECONSTRUCTIVE SURGERY, PC |
| Practice Address |
1490 Pantops Mountain Pl Suite 100 Charlottesville VA 22911-4601 |
| Mailing Address |
Po Box 5508 Virginia Beach VA 23471-0508 |
| Practice Telephone | 4342605130 |
| Practice Fax Number | 4349955948 |
| Mailing Telephone | 7573403489 |
| Mailing Fax Number | 7573404278 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-08-26 |
| Authorized Official Name | BRIAN M SHOWALTER (PRESIDENT/CEO) |
| Authorized Official Telephone | 4342605130 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
0101255390 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1023429818 | 05 |
| Street Address |
1490 PANTOPS MOUNTAIN PL SUITE 100 |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22911-4601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902889363 | Pantops Family Medicine Plc | Family Medicine | 1490 Pantops Mountain Pl, Suite 200, Charlottesville, VA 22911-4601 | 2005-11-21 |
| 1275159816 | Hannah M Duff | Physical Therapist | 1490 Pantops Mountain Pl, Charlottesville, VA 22911-4601 | 2020-06-19 |
| 1932648649 | Tidewater Physical Therapy, LLC | Occupational Therapist | 1490 Pantops Mountain Pl, Suite 202, Charlottesville, VA 22911-4601 | 2017-02-14 |
| 1790116309 | Pantops Family Medicine, A Division of Anchor Healthcare, Plc | Family Medicine | 1490 Pantops Mountain Pl, Suite 200, Charlottesville, VA 22911-4601 | 2013-12-07 |
| 1326380288 | Patricia F Stevens | Occupational Therapist | 1490 Pantops Mountain Pl, Charlottesville, VA 22911-4601 | 2013-03-19 |
| 1336454446 | Donna Lee Andris | Health Educator | 1490 Pantops Mountain Pl, Siute 202, Charlottesville, VA 22911-4601 | 2010-08-12 |
| 1871669382 | Pantops Physical Therapy, PC | Clinic/Center | 1490 Pantops Mountain Pl, Suite 202, Charlottesville, VA 22911-4601 | 2006-11-27 |
| 1205884962 | Charlottesville Radiology Ltd | Radiology | 1490 Pantops Mountain Pl, Suite 100, Charlottesville, VA 22911-4601 | 2006-05-05 |
| 1710966056 | Charlottesville Womens Services Plc | Obstetrics & Gynecology | 1490 Pantops Mountain Pl, Suite 105, Charlottesville, VA 22911-4601 | 2006-01-13 |
| 1497733000 | Alicia C Dagli | Family Medicine | 1490 Pantops Mountain Pl, Suite 200, Charlottesville, VA 22911-4601 | 2006-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760840912 | Hearing At Home | Hearing Instrument Specialist | 103 Free Brige Ln, Charlottesville, VA 22911 | 2016-02-03 |
| 1649637752 | Ebony Cosby | Contractor | 2500 Boulders Rd, Charlottesville, VA 22911 | 2016-01-20 |
| 1629452727 | Ahmed M Murtuza | Pharmacist | 925 Dorchester Pl Apt. 103, Charlottesville, VA 22911 | 2015-07-17 |
| 1083093231 | Kimberly P Tran | Dentist | 1470 Pantops Mountain Pl Ste 1, Charlottesville, VA 22911 | 2015-05-20 |
| 1508252982 | Alexandra M Bender | Family Medicine | 3263 Proffit Rd Ste 201, Charlottesville, VA 22911 | 2015-04-13 |
| 1538599980 | Commonwealth Dental Anesthesiology Inc | Clinic/Center | 1460-b Pantops Mountain Place, Charlottesville, VA 22911 | 2013-11-21 |
| 1831386606 | Hudson Chiropractic P.C. | Chiropractor | 103-a Free Bridge Lane, Charlottesville, VA 22911 | 2007-09-26 |
| 1386863421 | Laura P Smith | Specialist | 595 Peter Jefferson Parkway Suite 390, Reproductive Medicine and Surgery Center of Va, Charlottesville, VA 22911 | 2007-04-25 |
| 1609928621 | Bl Enterprises, LLC | Physical Therapist | 1405 Rolkin Court, Suite 102, Charlottesville, VA 22911 | 2007-01-18 |
| 1972660959 | Kenneth I. Barron | Obstetrics & Gynecology | 630 Peter Jefferson Pkwy Ste 140b, Charlottesville, VA 22911 | 2007-01-02 |
| Find all providers in zip 22911 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174587141 | Victoria Lee Vastine | Surgery | 595 Martha Jefferson Dr Ste 280, Charlottesville, VA 22911-4669 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134619166 | Aesthetic Center for Plastic Surgery | Surgery | 6845 Elm St Ste 708, Mc Lean, VA 22101-3851 | 2018-05-15 |
| 1720504244 | Dominion Surgical Specialists, LLC | Surgery | 2755 Hartland Rd Ste 300, Falls Church, VA 22043-3545 | 2017-08-16 |
| 1215465646 | Dominion Plastic Surgery LLC | Surgery | 2755 Hartland Rd Ste 204, Falls Church, VA 22043-3544 | 2017-05-30 |
| 1609018928 | Nicholas R Galardi | Surgery | 300 Medical Pkwy Ste 316, Chesapeake, VA 23320-4985 | 2009-04-01 |
| 1285835488 | Julia Stevenson | Surgery | 300 Medical Pkwy Ste 300, Chesapeake, VA 23320-4985 | 2007-05-29 |
| 1952516734 | Richard Gordon Lewis Jr. | Surgery | 2331a Robious Station Cir, Midlothian, VA 23113-2124 | 2007-05-14 |
| 1184768939 | Roanoke Plastic Surgery Plc | Surgery | 1118 First Street Sw, Roanoke, VA 24016-4702 | 2007-02-16 |
| 1851402515 | Nadia P Blanchet | Surgery | 9210 Forest Hill Avenue, Suite B1, Richmond, VA 23235-6880 | 2006-08-31 |
| 1255449872 | Magee-rosenblum Plastic Surgery, Inc | Surgery | 5818 Harbour View Blvd Ste 200, Suffolk, VA 23435-3315 | 2006-08-25 |
| 1235158189 | Balvant Parashram Arora | Surgery | 1101 Sam Perry Blvd., Suite 121, Fredericksburg, VA 22401-4467 | 2006-07-19 |
| Find all providers with the same taxonomy | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22911 |
Please comment or provide details below to improve the information on MONTICELLO PLASTIC AND RECONSTRUCTIVE SURGERY, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.