MARY IMMACULATE HOSPITAL (NPI# 1265715932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265715932 |
| Entity Type | Organization |
| Organization Name | MARY IMMACULATE HOSPITAL |
| Other Organization Name | BON SECOURS GYNECOLOGIC ONCOLOGY SPECIALISTS |
| Practice Address |
500 Sentara Cir Suite 102 Williamsburg VA 23188-5727 |
| Practice Telephone | 7579849890 |
| Practice Fax Number | 7573456659 |
| Mailing Telephone | 7579849890 |
| Mailing Fax Number | 7573456659 |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-02-06 |
| Authorized Official Name | MICHAEL K KERNER (CEO) |
| Authorized Official Telephone | 7576735929 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY IMMACULATE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bon Secours Gynecologic Oncology Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629414867 | Mary Immaculate Hospital | Pharmacy | 12720 Mcmanus Blvd Ste 100, Newport News, VA 23602-4414 | 2013-05-15 |
| 1245364223 | Mary Immaculate Hospital | General Acute Care Hospital | 24 Night Heron Dr, Stony Brook, NY 11790-1108 | 2007-03-14 |
| 1316041924 | Mary Immaculate Hospital | Dentist | 11449 Sutphin Blvd, Jamaica, NY 11434-1022 | 2006-09-12 |
| 1194267229 | Mary Immaculate Hospital | Obstetrics & Gynecology | 12720 Mcmanus Blvd, Suite 301, Newport News, VA 23602-4414 | 2016-11-07 |
| 1689047979 | Mary Immaculate Hospital | Surgery | 12720 Mcmanus Blvd, Suite 203, Newport News, VA 23602-4414 | 2015-11-09 |
| 1356625073 | Mary Immaculate Hospital | Internal Medicine | 12720 Mcmanus Blvd, Suite 303, Newport News, VA 23602-4414 | 2011-09-29 |
| 1578841367 | Mary Immaculate Hospital | Internal Medicine | 885 Kempsville Rd, Suite 320, Norfolk, VA 23502-3800 | 2011-07-27 |
| 1962719666 | Mary Immaculate Hospital | Surgery | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2010-09-02 |
| 1003130394 | Mary Immaculate Hospital | Internal Medicine | 12720 Mcmanus Blvd, Suite 201, Newport News, VA 23602-4414 | 2010-03-16 |
| 1164685129 | Mary Immaculate Hospital | Clinic/Center | 14703 Warwick Blvd, Suite A, Newport News, VA 23608-3611 | 2008-07-09 |
| Street Address |
500 SENTARA CIR SUITE 102 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23188-5727 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528067014 | Mark Phillip Moniz | Surgery | 500 Sentara Cir, Suite 202, Williamsburg, VA 23188-5727 | 2005-07-18 |
| 1093129132 | Virginia Oncology Associates | Non-Pharmacy Dispensing Site | 500 Sentara Cir, Suite 203, Williamsburg, VA 23188-5727 | 2014-06-17 |
| 1902127632 | Charles William Green | Nurse Practitioner | 500 Sentara Cir, Suite 102, Williamsburg, VA 23188-5727 | 2010-06-16 |
| 1861720310 | Sentara Medical Group | Surgery | 500 Sentara Cir, Suite 202a, Williamsburg, VA 23188-5727 | 2009-11-20 |
| 1447411780 | Rebecca L Lofgren | Surgery | 500 Sentara Cir, Ste 202, Williamsburg, VA 23188-5727 | 2008-06-19 |
| 1881800274 | Sentara Medical Group | Surgery | 500 Sentara Cir, Ste 202, Williamsburg, VA 23188-5727 | 2007-05-15 |
| 1437363975 | Sentara Medical Group | Internal Medicine | 500 Sentara Cir, Suite 102, Williamsburg, VA 23188-5727 | 2007-05-10 |
| 1669684346 | Sentara Medical Group | Psychiatry & Neurology | 500 Sentara Cir, Suite 102, Williamsburg, VA 23188-5727 | 2007-05-04 |
| 1265559769 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 500 Sentara Cir, Ste 103, Williamsburg, VA 23188-5727 | 2007-03-22 |
| 1881783231 | Daynelle M Dedmond | Obstetrics & Gynecology | 500 Sentara Cir, Ste 102, Williamsburg, VA 23188 | 2006-10-12 |
| 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 | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881783231 | Daynelle M Dedmond | Obstetrics & Gynecology | 500 Sentara Cir, Ste 102, Williamsburg, VA 23188 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700434420 | Central Virginia Gynecologic Oncology PC | Obstetrics & Gynecology | 9101 Stony Point Dr # 3300, Richmond, VA 23235-1979 | 2019-08-27 |
| 1265951818 | Bon Secours Memorial Regional Medical Center Inc | Obstetrics & Gynecology | 1510 N 28th St Ste 305, Richmond, VA 23223-5311 | 2017-09-14 |
| 1225460900 | Sherilynn Hummel | Obstetrics & Gynecology | 372 Coles Road, Burgess, VA 22432-0639 | 2013-08-05 |
| 1184811614 | Christopher Kevin Mccann | Obstetrics & Gynecology | 12720 Mcmanus Blvd Ste 308, Newport News, VA 23602-4414 | 2007-09-28 |
| 1861592339 | Randal John West | Obstetrics & Gynecology | 9101 Stony Point Dr Ste 3300, Richmond, VA 23235-1979 | 2006-09-25 |
| 1811948383 | Janet L Osborne | Obstetrics & Gynecology | 1 Riverside Cir Ste 300m, Roanoke, VA 24016-4962 | 2006-05-12 |
| 1699733808 | Chad Andrew Hamilton | Obstetrics & Gynecology | 3289 Woodburn Rd Ste 320, Annandale, VA 22003 | 2006-05-04 |
| 1730156373 | John C Elkas | Obstetrics & Gynecology | 3289 Woodburn Rd, Suite 320, Annandale, VA 22003-6800 | 2006-03-02 |
| 1902348139 | Loudoun Medical Group . P.c | Obstetrics & Gynecology | 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 | 2016-11-04 |
| 1932654886 | Bon Secours - Richmond Community Hospital, Incorporated | Obstetrics & Gynecology | 5875 Bremo Rd, Suite G-7, Richmond, VA 23226 | 2016-08-22 |
| 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.