COREY CAVANAUGH (NPI# 1114345162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114345162 |
| Entity Type | Individual |
| Full Name | COREY CAVANAUGH |
| Credential | D.O |
| Practice Address |
1300 Jefferson Park Ave Charlottesville VA 22903-3363 |
| Mailing Address |
Po Box 9007 Charlottesville VA 22906-9007 |
| Practice Telephone | 4349241984 |
| Practice Fax Number | 4342444502 |
| Mailing Telephone | 4342951000 |
| Mailing Fax Number | 4349724266 |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
0102205641 | VA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9 Pinnacle Dr Ste A03, Fishersville, VA 229392367 | 8444728711 | 4342437708 |
| 661 University Ln Ste E, Orange, VA 229602243 | 5406613011 | 5406613009 |
| 75 Circle Pointe Dr, Zion Crossroads, VA 229426935 | 4349249009 | 4349249256 |
| 70 Medical Center Cir Ste 105, Fishersville, VA 229392273 | 5403325970 | 5403325043 |
| Street Address |
1300 JEFFERSON PARK AVE |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22903-3363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477555399 | Bruce C Carter | Ophthalmology | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2005-08-11 |
| 1760089981 | Loretta Raiford | Internal Medicine | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2020-10-01 |
| 1588270342 | Rachel K Murray | Dietitian, Registered | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2020-09-17 |
| 1992321616 | Kristina Marie Creadore | Optometrist | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2020-06-18 |
| 1215558762 | Allison Gossen | Genetic Counselor, MS | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2020-05-06 |
| 1508409061 | Molly Stevenson Bailey | Dietitian, Registered | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2019-10-28 |
| 1497398994 | Rebecca Shea Turner | Dietitian, Registered | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2019-10-28 |
| 1215585443 | Katherine Emma Connell | Nurse Practitioner | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2019-08-30 |
| 1639724263 | Casey Erin Cavanagh | Psychologist | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2019-08-09 |
| 1679128482 | Jia Yu Liu | Optometrist | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2019-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326671009 | Ticynn Symone London | Specialist/Technologist | 723 Retriever Run, Ticynn London, Charlottesville, VA 22903 | 2020-02-20 |
| 1043853542 | Elaine Mccall | Dietitian, Registered | 1335 Jefferson Park Ave, Charlottesville, VA 22903 | 2019-10-28 |
| 1205480753 | Sean Robert Bennett | Clinic/Center | 433 Ednam Drive, Charlottesville, VA 22903 | 2019-08-01 |
| 1922562818 | Lynn Owen Taggart | Student in an Organized Health Care Education/Training Program | 300 Grassmere Rd, Charlottesville, VA 22903 | 2019-01-25 |
| 1831636166 | Sarah Michelle Richin | Social Worker | 709 A West Main St, Charlottesville, VA 22903 | 2017-01-25 |
| 1962868851 | Kelly Stewart Maurer | Counselor | 3101 Fontaine Avenue, Charlottesville, VA 22903 | 2016-01-07 |
| 1831592039 | Bearley Dental PC | Dentist | 901 Preston Ave, Suite 200, Charlottesville, VA 22903 | 2014-10-01 |
| 1730437823 | Frances Eva Demmerle | Neuromusculoskeletal Medicine & OMM | 1149 Rose Hill Dr., Charlottesville, VA 22903 | 2012-08-21 |
| 1801142229 | University of Virginia | General Acute Care Hospital | 1925 Beechcrest Court, Charlottesville, VA 22903 | 2012-08-03 |
| 1407123516 | Laura P. Handler | Counselor | 500 Old Lynchburg Rd., Region Ten Csb, Charlottesville, VA 22903 | 2011-11-18 |
| Find all providers in zip 22903 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1770858847 | Amanda D. Renaghan | Internal Medicine | 199 Spotnap Rd Ste 1, Charlottesville, VA 22911-8827 | 2012-03-21 |
| 1275720559 | Martha Jefferson Medical Group LLC | Internal Medicine | 590 Peter Jefferson Pkwy Ste 300, Charlottesville, VA 22911-4628 | 2007-10-01 |
| 1679618763 | Mark D. Okusa | Internal Medicine | The Kidney Center Uva Hospital W, Hospital Drive, 5th Floor, Charlottesville, VA 22908-0001 | 2007-02-20 |
| 1174502413 | Jefferson Nephrology, Ltd | Internal Medicine | 675 Peter Jefferson Pkwy, Suite 140, Charlottesville, VA 22911-8618 | 2006-01-13 |
| 1760822704 | Jeanne Kamal | Internal Medicine | 1300 Jefferson Park Ave, Charlottesville, VA 22903 | 2013-07-03 |
| 1710266259 | Samuel Aaron Lazoff | Internal Medicine | 1300 Jefferson Park Ave, Charlottesville, VA 22903-3363 | 2011-08-15 |
| 1831400696 | Shabnum Haleem | Internal Medicine | 500 Martha Jefferson Dr Fl 5, Charlottesville, VA 22911 | 2010-06-27 |
| 1730310608 | Anjushree Kumar | Internal Medicine | 1300 Jefferson Park Ave, Charlottesville, VA 22908-3376 | 2009-07-27 |
| 1659519932 | Uta Erdbruegger | Internal Medicine | 650 Peter Jefferson Pkwy Ste 290, Charlottesville, VA 22911-8848 | 2009-01-26 |
| 1811156649 | Brendan T. Bowman | Internal Medicine | 4 Hospital Dr, Charlottesville, VA 22908-0001 | 2008-06-06 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22903 |
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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.