MARK R BLADERGROEN (NPI# 1124058342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124058342 |
| Entity Type | Individual |
| Full Name | MARK R BLADERGROEN |
| Credential | M.D. |
| Practice Address |
5875 Bremo Rd Suite G-5 Richmond VA 23226-1934 |
| Practice Telephone | 8042877840 |
| Practice Fax Number | 8042877845 |
| Mailing Telephone | 8042877840 |
| Mailing Fax Number | 8042877845 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 0101042193 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 7300221 | 05 | |
| VA | MEDICAL LICENSE | 0101042193 | 01 |
| DEA | BB1434086 | 01 | |
| VA | GROUP PTAN | C06778 | 01 |
| Street Address |
5875 BREMO RD SUITE G-5 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23226-1934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183484 | Gary Reuben Zeevi | Specialist | 5875 Bremo Rd, Mob South, Suite G-5, Richmond, VA 23226-1934 | 2005-06-10 |
| 1205486354 | Brianne Augusta Cohen | Nurse Practitioner | 5875 Bremo Rd, Mob South, Suite 209, Richmond, VA 23226 | 2019-09-19 |
| 1245729565 | Sarah Kathleen Agee | Registered Nurse | 5875 Bremo Rd, Richmond, VA 23226-1934 | 2018-05-02 |
| 1326572785 | Miranda Means | Physical Therapy Assistant | 5875 Bremo Rd, Suite 611, Richmond, VA 23226-1934 | 2017-04-12 |
| 1285168617 | Angela M. Denney Logan | Physical Therapist | 5875 Bremo Rd, Suite #611, Richmond, VA 23226-1934 | 2017-04-12 |
| 1679013205 | Rachel A Licklider | Social Worker | 5875 Bremo Rd, Suite 311, Richmond, VA 23226-1934 | 2017-03-01 |
| 1174072193 | Mona Kaur | Nurse Practitioner | 5875 Bremo Rd, Suite 311, Richmond, VA 23226-1934 | 2016-10-03 |
| 1932654886 | Bon Secours - Richmond Community Hospital, Incorporated | Obstetrics & Gynecology | 5875 Bremo Rd, Suite G-7, Richmond, VA 23226 | 2016-08-22 |
| 1235582818 | Bon Secours - Richmond Community Hospital, Incorporated | Internal Medicine | 5875 Bremo Rd, Suite 209, Richmond, VA 23226 | 2016-07-19 |
| 1568832541 | Tara Thompson | Nurse Practitioner | 5875 Bremo Rd, Suite 601, Richmond, VA 23226-1934 | 2015-10-02 |
| Find all providers in the same location | ||||
| 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 | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003107467 | Katherine Marie Klein | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1250 E Marshall St # 980645, Richmond, VA 23298-5051 | 2011-04-20 |
| 1639337769 | Kyle W Yancey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1100 Reid Pkwy Ste 240, Richmond, IN 47374-1157 | 2008-05-27 |
| 1982882783 | Uttam Tripathy Md Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1601 Main Street, 500a, Richmond, TX 77469 | 2008-02-04 |
| 1285841288 | Leo M Gazoni | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7101 Jahnke Rd Ste 500, Richmond, VA 23225-4017 | 2007-05-17 |
| 1356459697 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5875 Bremo Rd Ste 400b, Richmond, VA 23226 | 2006-08-28 |
| 1598729618 | John F Kuhn | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2710 Royal Troon Dr, Richmond, IN 47374-7431 | 2006-04-14 |
| 1518476167 | Ivan Michael Rebeyka | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1000 E Broad St, Richmond, VA 23219-1930 | 2017-09-27 |
| 1396150769 | Arturo Cardounel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 N 11th St, Richmond, VA 23298-5024 | 2014-06-24 |
| 1649612318 | Luigi Lagazzi Garros | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 417 N 11th St, Richmond, VA 23298-5002 | 2013-07-23 |
| 1639483209 | Paul Brody Wehman | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5875 Bremo Rd Ste 400b, Richmond, VA 23226-1928 | 2010-08-05 |
| Find all providers in RICHMOND | ||||
Please comment or provide details below to improve the information on MARK R BLADERGROEN.
| 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.