SENTARA MEDICAL GROUP (NPI# 1174883474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174883474 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA CARDIOLOGY SPECIALISTS |
| Practice Address |
9507 Hospital Ave Nassawadox VA 23413-0017 |
| Mailing Address |
Po Box 17 9507 Hospital Ave Nassawadox VA 23413-0017 |
| Practice Telephone | 8004428000 |
| Mailing Telephone | 8004428000 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |
| 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 |
9507 HOSPITAL AVE |
| City | NASSAWADOX |
| State | VA |
| Zip Code | 23413-0017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588655302 | James Kaye | Specialist | 9507 Hospital Ave, Nassawadox, VA 23413 | 2005-11-01 |
| 1447556097 | Riverside Physician Services Inc | Internal Medicine | 9507 Hospital Ave, 3rd Floor, Nassawadox, VA 23413 | 2011-01-31 |
| 1346564697 | Shore Health Services, Inc | Family Medicine | 9507 Hospital Ave, Nassawadox, VA 23413-0718 | 2010-03-16 |
| 1811219751 | Shore Health Services, Inc | General Practice | 9507 Hospital Ave, Nassawadox, VA 23413-0017 | 2010-02-19 |
| 1922202340 | Rebecca Laura Downey | Anesthesiology | 9507 Hospital Ave, Nassawadox, VA 23413-0017 | 2007-06-11 |
| 1043432610 | Shore Health Services, Inc | Emergency Medicine | 9507 Hospital Ave, Nassawadox, VA 23413 | 2007-05-03 |
| 1962579193 | Shore Health Services Inc | Psychiatric Unit | 9507 Hospital Ave, Nassawadox, VA 23413 | 2006-11-30 |
| 1114097771 | Shore Health Services Inc | Medicare Defined Swing Bed Unit | 9507 Hospital Ave, Nassawadox, VA 23413 | 2006-11-09 |
| 1205906864 | Shore Health Services Inc | Skilled Nursing Facility | 9507 Hospital Ave, Nassawadox, VA 23413 | 2006-11-09 |
| 1659440006 | Shirley M. Randall Inc | Anesthesiology | 9507 Hospital Ave, Nassawadox, VA 23413 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265920805 | Shawn W Butler | Hearing Instrument Specialist | 9502 Hospital Ave., Nassawadox, VA 23413 | 2018-04-30 |
| 1649726522 | John Willis Konkel | Counselor | 10129 Rogers Drive, Nassawadox, VA 23413 | 2016-08-30 |
| 1154694065 | Jeanette M Sessoms | Nurse Practitioner | 9524 Hospital Ave., Nassawadox, VA 23413 | 2012-02-23 |
| 1609990308 | Shore Health Services, Inc | Surgery | 10111 Rogers Drive, Nassawadox, VA 23413 | 2007-03-19 |
| 1447329370 | Family Practice Associates | Family Medicine | 9506 Hospital Avenue, Nassawadox, VA 23413 | 2006-11-07 |
| 1669567632 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 7114 Lankford Highway, Nassawadox, VA 23413 | 2006-10-04 |
| 1134212939 | Debra Castner | Nurse Practitioner | 9550 Hospital Ave, Po Box 923, Nassawadox, VA 23413 | 2006-10-02 |
| 1093810384 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 9550 Hospital Avenue, Nassawadox, VA 23413 | 2006-09-13 |
| 1346353570 | Federico Fernando Molera | Anesthesiology | 9507 Rogers Ave, Nassawadox, VA 23413 | 2006-08-15 |
| 1710920020 | Rayfield's Pharmacy Inc | Pharmacy | 9502 Hospital Ave, Nassawadox, VA 23413 | 2006-06-14 |
| Find all providers in zip 23413 | ||||
| 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 |
|---|---|---|---|---|
| 1447556097 | Riverside Physician Services Inc | Internal Medicine | 9507 Hospital Ave, 3rd Floor, Nassawadox, VA 23413 | 2011-01-31 |
| 1851386114 | Lloyd Joseph Kellam IIi | Internal Medicine | 9524 Hospital Ave, Nassawadox, VA 23413 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482102 | Careclix Inc | Internal Medicine | 206 N Washington St Ste 100, Alexandria, VA 22314-2534 | 2020-03-14 |
| 1962046763 | Southpark Vascular Center | Internal Medicine | 445 Charles H Dimmock Pkwy Ste 101, Colonial Heights, VA 23834-2990 | 2019-11-05 |
| 1205496866 | United Diagnostic Services LLC | Internal Medicine | 4115 Annandale Rd Ste 301d, Annandale, VA 22003-2500 | 2019-06-17 |
| 1790348365 | Virginia Hospital Center Physician Group LLC | Internal Medicine | 1625 N George Mason Dr Ste 354, Arlington, VA 22205-3687 | 2019-04-18 |
| 1366905523 | Premier Cardiac and Vascular LLC | Internal Medicine | 5514 Alma Ln Ste 200, Springfield, VA 22151-4014 | 2019-04-12 |
| 1083133144 | Community Cardiology | Internal Medicine | 43 Rives Rd Ste 201, Petersburg, VA 23805-9255 | 2017-09-11 |
| 1306361803 | Stateline Heart and Vascular Health, Inc | Internal Medicine | 312 Fairy Street Ext Ste 101, Martinsville, VA 24112-1912 | 2017-08-07 |
| 1265954747 | Sentara Medical Group | Internal Medicine | 1933 Edwin Dr Ste 208a, Chesapeake, VA 23322-6531 | 2017-07-17 |
| 1003366618 | Bluefield Vascular Center | Internal Medicine | 970 Leatherwood Ln, Bluefield, VA 24605-2047 | 2016-10-06 |
| 1770947806 | Rajiv Ashok Kabadi | Internal Medicine | Vcuhs Department of Cards Fellowship, 980509, 1250 E. Marshall Street, Richmond, VA 23298-0509 | 2016-04-05 |
| Find all providers with the same taxonomy | ||||
| City | NASSAWADOX |
| Zip Code | 23413 |
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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.