BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. (NPI# 1063799302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063799302 |
| Entity Type | Organization |
| Organization Name | BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. |
| Other Organization Name | GLEN ALLEN INTERNAL MEDICINE |
| Practice Address |
5207 Hickory Park Dr Suite A Glen Allen VA 23059-2624 |
| Practice Telephone | 8046122980 |
| Practice Fax Number | 8047627102 |
| Mailing Telephone | 8046122980 |
| Mailing Fax Number | 8047627102 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2018-10-24 |
| Authorized Official Name | GEORGE O BUTLER (DIRECTOR CORPORATE RESPONSIBILITY) |
| Authorized Official Telephone | 8042810271 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | GROUP PTAN | C06778 | 01 |
| Other Name | Type Code |
|---|---|
| Glen Allen Internal Medicine | 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 |
5207 HICKORY PARK DR SUITE A |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543387 | Shelley B. Woodley | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2005-10-24 |
| 1568899409 | Bon Secours Virginia Medical Group I, LLC | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-10-10 |
| 1518301050 | Jason Anthony Leone | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-04-27 |
| 1275829673 | Allison B Trevillian | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-06-23 |
| 1629377221 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-03-22 |
| 1811294614 | Shannon Jeanette Cannon | Registered Nurse | 5207 Hickory Park Dr, Suite C, Glen Allen, VA 23059-2624 | 2011-02-15 |
| 1972783918 | Bon Secours-virginia Healthsource | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059 | 2007-11-07 |
| 1407053713 | Aysha Habib | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2007-06-29 |
| 1720157357 | Julia K. Padgett | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2006-11-07 |
| 1699731554 | Jill Elaine Ryland | Pediatrics | 5207 Hickory Park Dr, Suite C, Glen Allen, VA 23059-2624 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1114564721 | Dada Bhagwan Inc | Internal Medicine | 5028 Hickory Meadows Pl, Glen Allen, VA 23059-2653 | 2019-12-02 |
| 1053715615 | Allyalign Health, Inc. | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2014-10-10 |
| 1679809727 | Bruce Margolis | Internal Medicine | 3828 Nightmuse Way, Glen Allen, VA 23059-4800 | 2009-10-26 |
| 1235368184 | Deepa Nandyal | Internal Medicine | 4508 Yorkminster Dr, Glen Allen, VA 23060-6157 | 2009-07-13 |
| 1558464073 | Deborah Josefson | Internal Medicine | 4355 Innslake Drive, Glen Allen, VA 23060 | 2006-09-07 |
| 1104854488 | Randall Morris | Internal Medicine | 10150 Staples Mill Rd, Suite E, Glen Allen, VA 23060-3452 | 2006-06-28 |
| 1992761423 | Springfield Medical Center, P.C. | Internal Medicine | 3970 Springfield Rd, Glen Allen, VA 23060-4119 | 2006-04-24 |
| 1477526507 | Charles W Brandt | Internal Medicine | 4900 Cox Rd, Suite 150, Glen Allen, VA 23060-6295 | 2006-02-09 |
| 1780073924 | Palmetto Long-term Care Coalition | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2015-01-12 |
| 1154649721 | Jacqueline M Stewart | Internal Medicine | 10150 Staples Mill Rd, Suite E, Glen Allen, VA 23060-3452 | 2010-05-06 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23059 |
Please comment or provide details below to improve the information on BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC..
| 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.