SENTARA MEDICAL GROUP (NPI# 1104186428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104186428 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA CARDIOLOGY SPECIALISTS |
| Practice Address |
2075 Glenn Mitchell Dr Ste 400 Virginia Beach VA 23456-0179 |
| Practice Telephone | 7575078900 |
| Mailing Telephone | 7575078900 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2013-05-22 |
| Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572523344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Cardiology Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533375 | Sentara Medical Group | Internal Medicine | 1101 First Colonial Rd Ste 300, Virginia Beach, VA 23454-2409 | 2019-11-20 |
| 1285115998 | Sentara Medical Group | Surgery | 397 Little Neck Rd Ste 110, Virginia Beach, VA 23452-5774 | 2018-08-22 |
| 1336627207 | Sentara Medical Group | Emergency Medicine | 844 Kempsville Rd Ste 103, Norfolk, VA 23502 | 2018-08-02 |
| 1073010369 | Sentara Medical Group | Preventive Medicine | 2760 Godwin Blvd Ste 101, Suffolk, VA 23434-8501 | 2018-04-12 |
| 1376043489 | Sentara Medical Group | Internal Medicine | 301 Riverview Ave Ste 670, Norfolk, VA 23510-1065 | 2018-02-15 |
| 1629586417 | Sentara Medical Group | Surgery | 1051 Loftis Blvd Ste 210, Newport News, VA 23606-3069 | 2018-01-16 |
| 1558879346 | Sentara Medical Group | Family Medicine | 301 Riverview Ave Ste 930, Norfolk, VA 23510-1068 | 2018-01-16 |
| 1942724620 | Sentara Medical Group | Surgery | 500 Sentara Cir Ste 100, Williamsburg, VA 23188-5727 | 2017-08-03 |
| 1265954747 | Sentara Medical Group | Internal Medicine | 1933 Edwin Dr Ste 208a, Chesapeake, VA 23322-6531 | 2017-07-17 |
| 1487195111 | Sentara Medical Group | Clinical Medical Laboratory | 1933 Edwin Dr, Suite 104, Chesapeake, VA 23322-6531 | 2017-03-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Sentara Medical Group | 835 Glenrock Road, Norfolk, Virginia 23502 |
| System for Award Management (SAM) Entities | SENTARA MEDICAL GROUP | 863 Glenrock Rd Ste 208, Norfolk, VA 23502-3701 |
| North Carolina Corporations | Sentara medical Group | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Street Address |
2075 GLENN MITCHELL DR STE 400 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23456-0179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639222797 | Melissa J Buchberg | Obstetrics & Gynecology | 2075 Glenn Mitchell Dr, Suite 410, Virginia Beach, VA 23456-0179 | 2007-01-19 |
| 1720530629 | Kelly Graham | Nurse Practitioner | 2075 Glenn Mitchell Dr, Suite 500, Virginia Beach, VA 23456-0179 | 2016-10-26 |
| 1336692524 | Amber Lynn Sourbeer | Physician Assistant | 2075 Glenn Mitchell Dr, Ste 400, Virginia Beach, VA 23456-0179 | 2016-07-25 |
| 1790166692 | Melody Lynne Osborne | Physician Assistant | 2075 Glenn Mitchell Dr, Suite 512, Virginia Beach, VA 23456-0179 | 2015-06-16 |
| 1316284979 | Sentara Medical Group | Surgery | 2075 Glenn Mitchell Dr, Ste 506, Virginia Beach, VA 23456-0179 | 2013-01-15 |
| 1467720763 | Sentara Medical Group | Surgery | 2075 Glenn Mitchell Dr, Ste 512, Virginia Beach, VA 23456-0019 | 2011-12-01 |
| 1619251089 | Sentara Medical Group | Surgery | 2075 Glenn Mitchell Dr, Ste 512a, Virginia Beach, VA 23456-0019 | 2011-10-04 |
| 1366774192 | Susan Edmondson Phillips | Genetic Counselor, MS | 2075 Glenn Mitchell Dr, Suite 500, Virginia Beach, VA 23456-0179 | 2010-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336679349 | Joelene Grandy | Contractor | 1892 Riverrock Arch, Virginia Beach, VA 23456 | 2017-06-13 |
| 1023568995 | Red Mill Pediatric Dentistry and Behl Orthodontics Pllc | Dentist | 2033 Fisher Arch, Ste 100, Virginia Beach, VA 23456 | 2016-10-04 |
| 1609235803 | Maria Teresa Olivas | Registered Nurse | 3212 Fluuanna Circle, Virginia Beach, VA 23456 | 2016-02-16 |
| 1326434747 | Catharine White Cartwright | Physician Assistant | 2501 James Madison Blvd, Virginia Beach, VA 23456 | 2015-04-13 |
| 1598153785 | Harris Teeter LLC | Pharmacy | 2105 Princess Anne Road, Suite 100, Virginia Beach, VA 23456 | 2014-12-23 |
| 1881034023 | Kimberly Ann Benson | Dentist | 2105 Princess Anne Road, Suite 108, Virginia Beach, VA 23456 | 2013-07-02 |
| 1124378450 | Phyllis A. Wilson | Psychologist | 1249 Eagle Way, Virginia Beach, VA 23456 | 2012-09-13 |
| 1033477807 | Wolfgang J. Bay | Dentist | 1625 Salem Road #101, Virginia Beach, VA 23456 | 2012-04-30 |
| 1881974475 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2232 General Booth Blvd, Virginia Beach, VA 23456 | 2011-08-26 |
| 1780988857 | Casey Snyder | Dentist | 2484 North Landing Road, Virginia Beach, VA 23456 | 2011-01-05 |
| Find all providers in zip 23456 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1346371184 | Peem Lorvidhaya | Internal Medicine | 1708 Old Donation Pkwy., Virginia Beach, VA 23454 | 2007-03-07 |
| 1821024597 | Cardiology Consultants, Ltd | Internal Medicine | 205 Business Park Dr, Suite 200, Virginia Beach, VA 23462-6535 | 2006-06-24 |
| 1699717116 | Center for Heart and Vascular Studies LLC | Internal Medicine | 1531 Amberley Forest Rd, Virginia Beach, VA 23453-4706 | 2006-06-11 |
| 1689640039 | Ronald S Mckechnie | Internal Medicine | 2075 Glenn Mitchell Dr Ste 400, Virginia Beach, VA 23456-0179 | 2006-02-27 |
| 1740254440 | John Joseph Griffin Jr. | Internal Medicine | 1708 Old Donation Pkwy, Virginia Beach, VA 23454-3064 | 2006-02-17 |
| 1588711386 | David Adler | Internal Medicine | 2075 Glenn Mitchell Dr Ste 400, Virginia Beach, VA 23456-0179 | 2007-01-04 |
| 1164431102 | Chesapeake Bay Cardiology, P. C. | Internal Medicine | 1020 Independence Blvd, Suite 102, Virginia Beach, VA 23455-5500 | 2006-08-07 |
| 1255367694 | Ramanaiah Kakani | Internal Medicine | 2075 Glenn Mitchell Dr Ste 400, Virginia Beach, VA 23456-0179 | 2006-06-25 |
| 1467488106 | Gunadhar Panigrahi | Internal Medicine | 1925 Glenn Mitchell Dr, Suite 202, Virginia Beach, VA 23456-0170 | 2006-06-24 |
| 1487699096 | Partha Manchikalapudi | Internal Medicine | 844 Kempsville Rd, Suite 204, Virginia Beach, VA 23464 | 2006-06-18 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23456 |
Please comment or provide details below to improve the information on SENTARA MEDICAL GROUP.
| 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.