SENTARA MEDICAL GROUP (NPI# 1134360274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134360274 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA VASCULAR SPECIALISTS |
| Practice Address |
400 Sentara Cir Ste 450 Williamsburg VA 23188-5716 |
| Practice Telephone | 7573454460 |
| Mailing Telephone | 7573454460 |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2011-11-28 |
| 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 |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Vascular 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 |
400 SENTARA CIR STE 450 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23188-5716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255325254 | Kerry C Prewitt | Internal Medicine | 400 Sentara Cir, Ste 320, Williamsburg, VA 23188-5716 | 2005-09-06 |
| 1508317884 | Yasmin Nuru | Nurse Practitioner | 400 Sentara Cir, Suite 450, Williamsburg, VA 23188-5716 | 2016-10-20 |
| 1912378662 | Urology of Virgina, Pllc | Urology | 400 Sentara Cir, Suite 310 Geddy Outpatient Center, Williamsburg, VA 23188-5716 | 2015-10-07 |
| 1225398936 | L&e Medical Associates LLC | Emergency Medicine | 400 Sentara Cir, Williamsburg, VA 23188-5716 | 2012-05-29 |
| 1942585310 | Williamsburg Emergency Physicians | Emergency Medicine | 400 Sentara Cir, Williamsburg, VA 23188-5716 | 2011-10-18 |
| 1033444039 | Sentara Medical Group | Internal Medicine | 400 Sentara Cir, Ste 320a, Williamsburg, VA 23188-5716 | 2009-10-08 |
| 1265668578 | Sentara Medical Group | Pediatrics | 400 Sentara Cir, Suite 310, Williamsburg, VA 23188-5716 | 2009-06-02 |
| 1164665824 | Sentara Medical Group | Durable Medical Equipment & Medical Supplies | 400 Sentara Cir, Suite 320, Williamsburg, VA 23188-5716 | 2009-04-10 |
| 1952556144 | Bonnie Webster Cooley | Nurse Practitioner | 400 Sentara Cir, Ste. 450, Williamsburg, VA 23188-5716 | 2008-12-01 |
| 1457553125 | Sentara Medical Group | Internal Medicine | 400 Sentara Cir, Ste 320, Williamsburg, VA 23188-5716 | 2007-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
| 1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
| 1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
| 1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
| 1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
| 1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
| 1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
| 1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
| 1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
| 1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
| Find all providers in zip 23188 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942724620 | Sentara Medical Group | Surgery | 500 Sentara Cir Ste 100, Williamsburg, VA 23188-5727 | 2017-08-03 |
| 1083709737 | Michael E Landis | Surgery | 400 Sentara Cir Ste 350, Williamsburg, VA 23188-5716 | 2006-10-04 |
| 1649296286 | Riverside Physician Services Inc | Surgery | 156 Strawberry Plains Rd Ste A, Williamsburg, VA 23188-3409 | 2006-07-15 |
| 1104880160 | Russell Witter Campbell | Surgery | 156 Strawberry Plains Rd, Suite A, Williamsburg, VA 23188-3409 | 2006-04-14 |
| 1841567336 | Sentara Medical Group | Surgery | 400 Sentara Cir Ste 350, Williamsburg, VA 23188 | 2011-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670930 | Usa Vein Clinics of Chantilly LLC | Surgery | 3914 Centreville Rd Ste 125, Chantilly, VA 20151-3289 | 2019-07-11 |
| 1285115998 | Sentara Medical Group | Surgery | 397 Little Neck Rd Ste 110, Virginia Beach, VA 23452-5774 | 2018-08-22 |
| 1629586417 | Sentara Medical Group | Surgery | 1051 Loftis Blvd Ste 210, Newport News, VA 23606-3069 | 2018-01-16 |
| 1972980761 | Carlos Jose Torres-medina | Surgery | 500 J Clyde Morris Blvd # 603, Newport News, VA 23601-1929 | 2015-04-30 |
| 1306280128 | Justin Marc Milligan | Surgery | 397 Little Neck Rd Ste 120, Virginia Beach, VA 23452-5774 | 2013-04-23 |
| 1578817938 | Clinch Valley Vascular Surgical Assoc., Pllc | Surgery | 6719 Gov. G.c. Peery Highway, Suite 2600, Richlands, VA 24641 | 2012-11-06 |
| 1346503463 | Mid Atlantic Vascular Holding, LLC | Surgery | 1415 Eastridge Rd, Richmond, VA 23229-5501 | 2012-06-22 |
| 1265791297 | Vascular Surgery Group | Surgery | 850 Chistensen Court, Great Falls, VA 22066 | 2012-05-11 |
| 1902122922 | Hao Duy Pham | Surgery | 6719 Governor Gc Peery Hwy Ste 2600, Richlands, VA 24641 | 2010-04-15 |
| 1740421049 | Djurabek Babadjanov | Surgery | 500 J Clyde Morris Blvd Ste 603, Newport News, VA 23601-1929 | 2009-03-16 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSBURG |
| Zip Code | 23188 |
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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.