BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. (NPI# 1063772143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063772143 |
| Entity Type | Organization |
| Organization Name | BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. |
| Other Organization Name | BON SECOURS INFECTIOUS DISEASE SPECIALISTS |
| Practice Address |
5855 Bremo Rd Ste 306 Richmond VA 23226-1923 |
| Mailing Address |
8580 Magellan Pkwy Richmond VA 23227-1149 |
| Practice Telephone | 8046732814 |
| Practice Fax Number | 8046732873 |
| Mailing Fax Number | 8664490896 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | STEPHAN QUIRICONI (CFO) |
| Authorized Official Telephone | 8042818301 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | GROUP PTAN | C06778 | 01 |
| Other Name | Type Code |
|---|---|
| Bon Secours Infectious Disease Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194360503 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5899 Bremo Rd Ste 202, Richmond, VA 23226-1935 | 2019-11-08 |
| 1346741667 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100, Richmond, VA 23233 | 2018-02-22 |
| 1215438544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100a, Richmond, VA 23233 | 2018-02-22 |
| 1508388554 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Surgery | 5875 Bremo Rd Ste 110, Richmond, VA 23226-1934 | 2017-07-12 |
| 1255776290 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 2401 W Leigh Street, Richmond, VA 23220-1328 | 2013-05-03 |
| 1639430093 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Psychologist | 5855 Bremo Rd Ste 404, Mob North, Richmond, VA 23226-1924 | 2012-06-01 |
| 1548529126 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Pediatrics | 5855 Bremo Rd Ste 605, Richmond, VA 23226-1926 | 2012-05-16 |
| 1508125386 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 1501 Maple Ave Ste 100, Richmond, VA 23226-2553 | 2012-05-14 |
| 1013280544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5875 Bremo Rd Ste G11, Mob South, Richmond, VA 23226-1934 | 2012-02-14 |
| 1265736680 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Pediatrics | 5855 Bremo Rd Ste 703, Richmond, VA 23226-1926 | 2010-12-28 |
| Street Address |
5855 BREMO RD STE 306 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23226-1923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649265950 | Jayashree Ravishankar | Internal Medicine | 5855 Bremo Rd Ste 306, Mob North, Richmond, VA 23226-1923 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625744 | Eye Surgeons of Richmond, Inc. | Eyewear Supplier (Equipment, not the service) | 5875 Bremo Rd Ste 606, Richmond, VA 23226 | 2017-12-18 |
| 1922517028 | Karen Margaret Karwowski | Physical Therapist | 1901 Charles Street, Crestview Elementary School, Henrico, VA 23226 | 2017-09-21 |
| 1831636463 | Tammy A Lewis | Nurse Practitioner | 5803 Bremo Road, Richmond, VA 23226 | 2017-01-20 |
| 1497116438 | Ashton Williams | Counselor | 2008 Libbie Avenue, Suite 101, Richmond, VA 23226 | 2016-03-18 |
| 1396110078 | Nino Carlo Deleon | Dentist | 5500 Monument Ave Ste G, Richmond, VA 23226 | 2015-12-07 |
| 1083097794 | Amy Michelle Kruger | Podiatrist | 2008 Bremo Rd Ste 100, Richmond, VA 23226 | 2015-06-30 |
| 1841682762 | James Bryce Lothian | Pediatrics | 5875 Bremo Road, Mob South, Suite 303, Pediatric Lung Care, Richmond, VA 23226 | 2015-03-02 |
| 1811334980 | Carmen Wong | Physical Medicine & Rehabilitation | 1901 Libbie Ave, Richmond, VA 23226 | 2013-05-30 |
| 1841533890 | Lauren Etz Freeman | Nurse Practitioner | 7113 Three Chopt Road, Suite 101, Pediatric Associates of Richmond, Inc., Richmond, VA 23226 | 2013-03-28 |
| 1609126044 | Tammy Denise Mills | Nurse Practitioner | 1501 Maple Ave Ste 301, Richmond, VA 23226 | 2012-09-13 |
| Find all providers in zip 23226 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790075901 | Jillian Eileen Raybould | Internal Medicine | 1000 E Marshall St, Vmi Building, Suite 2015, Richmond, VA 23298-1901 | 2011-04-10 |
| 1760650386 | George Matthew Vail | Internal Medicine | 1050 Reid Pkwy Ste 205, Richmond, IN 47374-1159 | 2008-02-16 |
| 1134154677 | Vivian Bruzzese | Internal Medicine | 108 Cowardin Ave, Richmond, VA 23224-2020 | 2006-07-12 |
| 1760421473 | Edward Sang Wong | Internal Medicine | 2220 Edward Holland Drive, Richmond, VA 23230-2519 | 2006-06-06 |
| 1578501060 | Cjw Infectious Disease LLC | Internal Medicine | 7117 Jahnke Rd, Richmond, VA 23225-4017 | 2006-06-04 |
| 1649265950 | Jayashree Ravishankar | Internal Medicine | 5855 Bremo Rd Ste 306, Mob North, Richmond, VA 23226-1923 | 2005-09-13 |
| 1922008804 | Patricia Ann Barnwell | Internal Medicine | 793 Eastern Byp, Suite #206, Richmond, KY 40475-2422 | 2005-07-21 |
| 1073909990 | Nicole Claire Vissichelli | Internal Medicine | 1250 E Marshall St, Box 980509, Richmond, VA 23298-5051 | 2015-04-07 |
| 1013344944 | Bon Secours Virginia Medical Group I, LLC | Internal Medicine | 5855 Bremo Rd, Suite 102, Richmond, VA 23226-1930 | 2013-10-10 |
| 1316226475 | Baptist Health Richmond Inc | Internal Medicine | 789 Eastern Byp, Suite 25, Richmond, KY 40475-2415 | 2011-08-08 |
| Find all providers in RICHMOND | ||||
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| 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.