SENTARA MEDICAL GROU P (NPI# 1205168143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205168143 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROU P |
| Other Organization Name | SENTARA SURGERY SPECIALISTS |
| Practice Address |
5659 Parkway Dr Suite 210a Gloucester VA 23061-3792 |
| Practice Telephone | 7578272202 |
| Practice Fax Number | 7575109184 |
| Mailing Telephone | 7578272202 |
| Mailing Fax Number | 7575109184 |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2011-12-02 |
| 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 | 2086X0206X |
Surgery Specialization: Surgical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Surgery Specialists | Doing Business As Name - Organization |
| Street Address |
5659 PARKWAY DR SUITE 210A |
| City | GLOUCESTER |
| State | VA |
| Zip Code | 23061-3792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457326811 | Wendell T Poulsen Jr. | Family Medicine | 5659 Parkway Dr, Ste 100, Gloucester, VA 23061-3792 | 2006-02-21 |
| 1033625710 | Velocity Urgent Care, LLC | Clinic/Center | 5659 Parkway Dr, Gloucester, VA 23061-3792 | 2017-12-18 |
| 1710377742 | Sentara Medical Group | Internal Medicine | 5659 Parkway Dr, Ste 220, Gloucester, VA 23061-3792 | 2015-01-29 |
| 1235536426 | Sentara Medical Group | Internal Medicine | 5659 Parkway Dr, Ste 200, Gloucester, VA 23061-3792 | 2014-12-03 |
| 1659655744 | Sentara Medical Group | Surgery | 5659 Parkway Dr, Ste 200, Gloucester, VA 23061-3792 | 2011-10-06 |
| 1750680633 | Sentara Medical Group | Clinic/Center | 5659 Parkway Dr, Suite 100, Gloucester, VA 23061-3792 | 2011-03-18 |
| 1457683393 | Sentara Medical Group | Surgery | 5659 Parkway Dr, Suite 210b, Gloucester, VA 23061-3792 | 2010-02-03 |
| 1295969962 | Sentara Medical Group | Pediatrics | 5659 Parkway Dr, Suite 230, Gloucester, VA 23061-3782 | 2009-05-11 |
| 1851538201 | Sentara Medical Group | Pediatrics | 5659 Parkway Dr, Ste 230, Gloucester, VA 23061-3782 | 2009-01-07 |
| 1205086071 | Daniel E Pouchot, Dds, Pllc | Dentist | 5659 Parkway Dr, Suite 140, Gloucester, VA 23061-3782 | 2008-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770087546 | Connex Family Services | Behavioral Analyst | 6948 Main Street Ste. 12, Gloucester, VA 23061 | 2018-03-19 |
| 1699278820 | Blake Steagall | Counselor | 7296 York Avenue, Gloucester, VA 23061 | 2018-03-14 |
| 1982103941 | Cathyrn Fields Radford | Speech-Language Pathologist | Page Middle School, 5198 T. C. Walker Road, Gloucester, VA 23061 | 2018-02-06 |
| 1326558727 | Home Care Associates LLC | Technician | 6812 Teagle Lane, Unit 1, Gloucester, VA 23061 | 2017-10-11 |
| 1154847176 | Thorpe Counseling Center | Social Worker | 6486 Main Street, Suite 10, Gloucester, VA 23061 | 2017-08-22 |
| 1215473715 | Christina Vickers | Prevention Professional | 7824 Windy Hill Road, Gloucester, VA 23061 | 2017-01-09 |
| 1487084372 | Debra Leigh Ottarson | Pharmacist | 6634 Jarvis Road, Gloucester, VA 23061 | 2013-11-14 |
| 1114170446 | Riverside Physician Services Inc | Psychiatry & Neurology | 7547 Medial Drive, Suite 1300, Gloucester, VA 23061 | 2008-10-30 |
| 1881846087 | Nine Palms 1, LLC | Home Health | 6606 Main St, Gloucester, VA 23061 | 2008-10-21 |
| 1396909867 | Sandra B Buchheister | Physical Therapist | 6965 Fox Hunt Lane, Suite 201, Gloucester, VA 23061 | 2008-07-15 |
| Find all providers in zip 23061 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457683393 | Sentara Medical Group | Surgery | 5659 Parkway Dr, Suite 210b, Gloucester, VA 23061-3792 | 2010-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770976078 | John Edward Niederhuber | Surgery | 3300 Gallows Road; Floor 2, Claude Moore Bldg., Inova Health Care Services; Dba Inova Fairfax Hospital, Falls Church, VA 22042 | 2015-03-11 |
| 1013341171 | Surgical Support Services LLC | Surgery | 12439 Walnut Hill Drive, Rockville, VA 23146 | 2013-08-26 |
| 1477687283 | Craig L. Slingluff Jr. | Surgery | Uva Hospital West The Cancer Ctr, Hospital Drive, Charlottesville, VA 22908-0001 | 2007-03-15 |
| 1881763423 | Anneke T. Schroen | Surgery | 1300 Jefferson Park Ave Ste 1101, Charlottesville, VA 22903-3363 | 2006-11-07 |
| 1669436044 | Michael Anthony Covelli | Surgery | 200 Arh Ln 102, Low Moor, VA 24457 | 2006-04-13 |
| 1104801844 | Theresa Harrington Stukus | Surgery | 8318 Arlington Blvd Ste 305, Fairfax, VA 22031-5218 | 2005-12-14 |
| 1619976792 | Shawna Willey | Surgery | 8081 Innovation Park Dr, Fairfax, VA 22031-4867 | 2005-07-20 |
| 1508240797 | Nathan James Branson | Surgery | 11803 Jefferson Ave, Ste 235, Newport News, VA 23606-2565 | 2015-07-17 |
| 1396083721 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Surgery | 5855 Bremo Rd, Suite 606, Richmond, VA 23226-1930 | 2013-01-18 |
| 1033426150 | Marybeth Scavone Hughes | Surgery | 825 Fairfax Ave, Ste 610, Norfolk, VA 23507-1914 | 2010-09-10 |
| Find all providers with the same taxonomy | ||||
| City | GLOUCESTER |
| Zip Code | 23061 |
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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.