JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK LLC (NPI# 1134489214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134489214 |
| Entity Type | Organization |
| Organization Name | JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK LLC |
| Other Organization Name | JENCARE NEIGHBORHOOD MEDICAL CENTERS |
| Practice Address |
524 Southpark Blvd Colonial Heights VA 23834-3609 |
| Mailing Address |
1000 Park Centre Blvd #136 Miami FL 33169-5373 |
| Practice Telephone | 3056531770 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-09-04 |
| Authorized Official Name | MARY CHEN (ADMINISTRATOR) |
| Authorized Official Telephone | 3056531770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 174400000X | Specialist | 101249721 | VA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| JenCare Neighborhood Medical Centers | Doing Business As Name - Organization |
| Street Address |
524 SOUTHPARK BLVD |
| City | COLONIAL HEIGHTS |
| State | VA |
| Zip Code | 23834-3609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487626883 | Emerson Allen Joslyn Jr. | Internal Medicine | 524 Southpark Blvd, Colonial Heights, VA 23834-3609 | 2006-02-02 |
| 1508257106 | Laura Wong | Acupuncturist | 524 Southpark Blvd, Jencare Neighborhood Medical South Park, LLC, Colonial Heights, VA 23834-3609 | 2015-02-18 |
| 1033340377 | Samantha N Taylor | Nurse Practitioner | 524 Southpark Blvd, Colonial Heights, VA 23834 | 2009-08-04 |
| 1508006495 | Reman Dhaliwal | Podiatrist | 524 Southpark Blvd, Colonial Heights, VA 23834 | 2009-03-04 |
| 1376709980 | Preeti Dube | Internal Medicine | 524 Southpark Blvd, Colonial Heights, VA 23834-3609 | 2008-08-03 |
| 1073531604 | Patricia Jo Rodgers | Family Medicine | 524 Southpark Blvd, Colonial Heights, VA 23834-3609 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323040 | Latoya Harris | Social Worker | 3220 Loganwood Dr, South Chesterfield, VA 23834 | 2020-07-15 |
| 1619598653 | Jasmine Cutler | Nurse Practitioner | 445 Charles Dimmock Pkwy, Colonial Heights, VA 23834 | 2020-04-30 |
| 1942841275 | Stephanie Benedict | Technician | 330 King Fisher Way, Col. Heights, VA 23834 | 2019-10-08 |
| 1134628852 | Stacie J Lewis | Hearing Instrument Specialist | 320b Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2018-02-08 |
| 1073020194 | Colonial Heights Physicians, LLC | Emergency Medicine | 60 East Roslyn Court, Colonial Heights, VA 23834 | 2018-01-10 |
| 1639681349 | Nicholas C Vickers | Hearing Instrument Specialist | 320 B Charles Dimmock Pkwy, Suite 4, Colonial Heights, VA 23834 | 2017-11-03 |
| 1962935015 | Selfless Service LLC | In Home Supportive Care | 256 E Ellerslie Ave Ste C, Colonial Heights, VA 23834 | 2017-04-05 |
| 1134594864 | Dominion Aba | Early Intervention Provider Agency | 2903 Bouleavard, Colonial Heights, VA 23834 | 2015-12-07 |
| 1558743039 | Dream Care of Va LLC | Durable Medical Equipment & Medical Supplies | 130 Temple Lake Dr Ste 4, Colonial Heights, VA 23834 | 2015-06-22 |
| 1811311343 | Colonial Orthopaedics Inc | Orthopaedic Surgery | 325 Charles Dimmock Parkway, Suite 301, Colonial Heights, VA 23834 | 2014-02-04 |
| Find all providers in zip 23834 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295793727 | Carlton Edwin Miller | Specialist | 110 Dunlop Vlg, Colonial Heights, VA 23834-1764 | 2006-05-03 |
| 1194786251 | David C Cangcuesta | Specialist | 930 South Ave Ste 4b, Colonial Heights, VA 23834-3620 | 2006-03-29 |
| 1720388275 | Virginia Medical Group, PC | Specialist | 213 Temple Ave, Colonial Heights, VA 23834-2827 | 2010-11-01 |
| 1225240583 | Zvonko Spasic | Specialist | 439 Jennick Dr, Colonial Heights, VA 23834-4901 | 2007-05-07 |
| 1548369796 | Tri City Surgical Associates | Specialist | 930 South Ave, Suite 4 A, Colonial Heights, VA 23834-3621 | 2006-09-22 |
| 1316046287 | Cardiology Associates of Central Virginia, PC | Specialist | 89 Sherwood Dr, Colonial Heights, VA 23834-1447 | 2006-09-21 |
| 1548216427 | Carlton E.miller M.d.p.c | Specialist | 110 Dunlop Vlg, Colonial Heights, VA 23834-1764 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952004 | Patricia Maureen Williams | Specialist | 175 W Campus Dr, 110 Lr Hall, Blacksburg, VA 24061-1034 | 2020-11-02 |
| 1497360028 | Ann L Swanson | Specialist | 872 Garrow Rd, Newport News, VA 23608-3365 | 2020-09-10 |
| 1093338915 | Bridget Elizabeth Poindexter | Specialist | 103 Madison St Apt C, Radford, VA 24141-1878 | 2020-05-27 |
| 1285257246 | Zamjams Enterprises LLC | Specialist | 1600 N Coalter St Ste 7, Staunton, VA 24401-2500 | 2020-05-26 |
| 1427670538 | Megan Cone | Specialist | 6236 Willow Glen Rd, Midlothian, VA 23112-2230 | 2020-05-12 |
| 1033739529 | Maureen Marguerite Loftus | Specialist | 8321 Old Courthouse Rd Ste 130, Vienna, VA 22182-3817 | 2020-04-24 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1821626235 | Tidewater Surgical | Specialist | 1732 S Park Ct, Chesapeake, VA 23320-8934 | 2020-03-31 |
| 1699307520 | Latia Tisdale | Specialist | 2520 Professional Rd Ste D, North Chesterfield, VA 23235-3267 | 2020-02-08 |
| 1013473081 | Whitney Matheson | Specialist | 6803 Dallas Rd, Roanoke, VA 24019-2310 | 2019-02-14 |
| Find all providers with the same taxonomy | ||||
| City | COLONIAL HEIGHTS |
| Zip Code | 23834 |
Please comment or provide details below to improve the information on JENCARE NEIGHBORHOOD MEDICAL SOUTH PARK LLC.
| 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.