MINI-MEDIC (NPI# 1033441936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033441936 |
| Entity Type | Organization |
| Organization Name | MINI-MEDIC |
| Other Organization Name | GLENN R. MCDERMOTT, MD |
| Practice Address |
1788 Republic Rd Suite 400 Virginia Beach VA 23454-4552 |
| Practice Telephone | 7573434221 |
| Mailing Telephone | 7573434221 |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |
| Authorized Official Name | GLENN ROBERT MCDERMOTT (OWNER) |
| Authorized Official Telephone | 7573434221 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101034588 | VA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Glenn R. McDermott, MD | Doing Business As Name - Organization |
| Street Address |
1788 REPUBLIC RD SUITE 400 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-4552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225011935 | Robert Charles Beba | Physical Therapist | 1788 Republic Rd, Suite 100, Virginia Beach, VA 23454-4552 | 2005-11-28 |
| 1437555083 | Walko Enterprise Incorporated | Physical Medicine & Rehabilitation | 1788 Republic Rd, Virginia Beach, VA 23454 | 2014-11-10 |
| 1902109895 | Bayview Physician Services | Durable Medical Equipment & Medical Supplies | 1788 Republic Rd, Suite 300, Virginia Beach, VA 23454-4552 | 2010-12-15 |
| 1184897415 | William Zachary Fenn | Podiatrist | 1788 Republic Rd, Suite 300, Virginia Beach, VA 23454-4552 | 2008-04-08 |
| 1720205172 | The Doctor's In | Emergency Medicine | 1788 Republic Rd, Suite 400, Virginia Beach, VA 23454-4552 | 2007-04-19 |
| 1851329676 | Kathryn G Bragg | Physical Therapist | 1788 Republic Rd, Ste 200, Virginia Beach, VA 23454-4552 | 2006-06-29 |
| 1497783153 | Robert Michael Spear | Physical Medicine & Rehabilitation | 1788 Republic Rd, Ste 200, Virginia Beach, VA 23454-4552 | 2006-06-29 |
| 1346276268 | Dawn Michelle Pfeiffer | Podiatrist | 1788 Republic Rd, Suite 300, Virginia Beach, VA 23454-4552 | 2006-06-23 |
| 1851337794 | Cynthia C Su | Physical Medicine & Rehabilitation | 1788 Republic Rd, Ste 200, Virginia Beach, VA 23454-4552 | 2006-06-21 |
| 1356386841 | Atlantic Foot and Ankle Center | Podiatrist | 1788 Republic Rd, Suite 300, Virginia Beach, VA 23454-4552 | 2006-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652900 | Liliana Kim | Family Medicine | 2908 Pepperlin Dr, Virginia Beach, VA 23456-3524 | 2020-09-01 |
| 1699236026 | Helen Everett Frankos | Family Medicine | 748 Sequoia Way, Virginia Beach, VA 23451-4472 | 2019-03-28 |
| 1336644814 | Jessica Zuckerman | Family Medicine | 2309 Nettleford Way, Virginia Beach, VA 23453 | 2018-03-27 |
| 1538699038 | Promethean Group | Family Medicine | 3920 Vanderhorst Dr, Virginia Beach, VA 23462-7531 | 2017-06-16 |
| 1407385172 | Ashley Watson | Family Medicine | 513 Boswell Ct, Virginia Beach, VA 23452-5857 | 2017-06-07 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| 1053754358 | Jonathan Gellman | Family Medicine | 1200 Lake James Dr, Suite 200, Virginia Beach, VA 23464-6773 | 2013-04-17 |
| 1003155045 | Accurate Medical PC | Family Medicine | 3312 Doncaster Rd, Virginia Beach, VA 23452-5920 | 2013-02-12 |
| 1740529072 | Dalene Cheek Evans | Family Medicine | 1201 Lake James Dr Ste 200, Virginia Beach, VA 23464-6780 | 2013-02-06 |
| 1326334095 | Kari Ann Neamand Cheney | Family Medicine | 1035 Nider Blvd, St 100, Nmcp Branch Health Clinic Boone, Virginia Beach, VA 23459-2731 | 2011-06-21 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
Please comment or provide details below to improve the information on MINI-MEDIC.
| 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.