COMMONWEALTH PRIMARY CARE (NPI# 1336157858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336157858 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH PRIMARY CARE |
| Other Organization Name | CPC HOSPITALIST DIVISION |
| Practice Address |
4050 Innslake Dr Ste 308 Glen Allen VA 23060 |
| Mailing Address |
4050 Innslake Dr Ste 308 Glen Allen VA 23060-3327 |
| Practice Telephone | 8045215310 |
| Practice Fax Number | 8045215312 |
| Mailing Telephone | 8045215315 |
| Mailing Fax Number | 8045215312 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-11-08 |
| Authorized Official Name | MS. KELLY SHEPHERD (HOSPITALIST ADMINISTRATOR) |
| Authorized Official Telephone | 8045215315 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE RR | CC6597 | 01 |
| VA | ANTHEM BCBS | 139444 | 01 |
| VA | ANTHEM BCBS | 139440 | 01 |
| Other Name | Type Code |
|---|---|
| CPC Hospitalist Division | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831242353 | Commonwealth Primary Care | Physical Medicine & Rehabilitation | 4050 Innslake Dr Ste 308, Glen Allen, VA 23060 | 2007-01-19 |
| 1689609182 | Commonwealth Primary Care | Family Medicine | 1529 Huguenot Rd, Suite A, Midlothian, VA 23113-2426 | 2006-07-12 |
| 1407881907 | Commonwealth Primary Care | Radiology | 1109 West Marshall Street, Richmond, VA 23220 | 2006-07-12 |
| 1487011367 | Commonwealth Primary Care | Nurse Practitioner | 1800 Glenside Dr, Suite 103, Richmond, VA 23226-3769 | 2016-01-22 |
| 1982033411 | Commonwealth Primary Care | Clinic/Center | 1614 Peachtree Pkwy, Suite # 200, Cumming, GA 30041-6883 | 2013-11-05 |
| 1356532634 | Commonwealth Primary Care | Physical Medicine & Rehabilitation | 9930 Independence Park Dr, Suite 101, Richmond, VA 23233-1476 | 2007-08-05 |
| 1750571287 | Commonwealth Primary Care | Family Medicine | 1800 Glenside Dr Ste 105, Richmond, VA 23226-3769 | 2007-07-31 |
| 1487716676 | Commonwealth Primary Care | Family Medicine | 2200 Pump Rd, Suite 100, Richmond, VA 23233-3539 | 2006-12-14 |
| 1851464887 | Commonwealth Primary Care | Family Medicine | 5360 Twin Hickory Rd, Glen Allen, VA 23059-5682 | 2006-11-16 |
| 1780693804 | Commonwealth Primary Care | Family Medicine | 8903 Three Chopt Rd, Richmond, VA 23229 | 2006-08-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Commonwealth Primary Care Inc. | 1800 Glenside Dr, Ste 105, Richmond, Virginia 23226 |
| Street Address |
4050 INNSLAKE DR STE 308 |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598056491 | Scott W Blevins | Pharmacist | 4050 Innslake Dr, Suite 308, Glen Allen, VA 23060-3327 | 2011-04-26 |
| 1760717383 | R & S Rehab Services, LLC | Internal Medicine | 4050 Innslake Dr, Suite 308, Glen Allen, VA 23060-3327 | 2009-10-15 |
| 1336267491 | Innsbrook Plastic Surgery LLC | Clinic/Center | 4050 Innslake Dr, Suite 310, Glen Allen, VA 23060-3327 | 2007-03-27 |
| 1356435663 | Anand Aravindakshakurup | Internal Medicine | 4050 Innslake Dr, Suite 308, Glen Allen, VA 23060-3327 | 2006-10-03 |
| 1720170855 | Insook Lee | Internal Medicine | 4050 Innslake Dr, Suite 308, Glen Allen, VA 23060-3327 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469715 | Romy Sharieff | Midwife | 10433 Mountain Glen Pkwy, Glen Allen, VA 23060 | 2020-02-13 |
| 1366934549 | Guillermo Del Campo | Optometrist | 4114 Innslake Drive, Glen Allen, VA 23060 | 2018-06-04 |
| 1871013771 | Wecare Medical Transportation Inc. | Driver | 10524 Boscastle Rd, Glen Allen, VA 23060 | 2017-06-21 |
| 1265889570 | Darchelle Braxton Dmd PC | Dentist | 4300 Pouncey Tract Road Suite I, Glen Allen, VA 23060 | 2016-05-17 |
| 1952714842 | Gaynier Orthodontics PC | Clinic/Center | 4701 Cox Rx Ste 285, C/o Ct Corporation, Glen Allen, VA 23060 | 2014-06-09 |
| 1538507819 | Rca Laboratory Services, LLC | Clinical Medical Laboratory | 4060 Innslake Dr, Glen Allen, VA 23060 | 2013-06-10 |
| 1922352772 | Samantha S Stone | Physical Therapist | 4101 Cox Rd Ste 100, Glen Allen, VA 23060 | 2012-11-01 |
| 1609123660 | Stephanie Rene Matsko | Optometrist | 4114 Innslake Dr., Glen Allen, VA 23060 | 2012-08-09 |
| 1851661367 | Lateaka Sheri Vinson | Speech-Language Pathologist | 2250 Old Brick Rd, Suite 2229, Glen Allen, VA 23060 | 2012-01-01 |
| 1568774271 | Cynthia A Koza | Optometrist | 4600 Cox Road, Suite 120, Glen Allen, VA 23060 | 2010-07-10 |
| Find all providers in zip 23060 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1114564721 | Dada Bhagwan Inc | Internal Medicine | 5028 Hickory Meadows Pl, Glen Allen, VA 23059-2653 | 2019-12-02 |
| 1053715615 | Allyalign Health, Inc. | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2014-10-10 |
| 1679809727 | Bruce Margolis | Internal Medicine | 3828 Nightmuse Way, Glen Allen, VA 23059-4800 | 2009-10-26 |
| 1235368184 | Deepa Nandyal | Internal Medicine | 4508 Yorkminster Dr, Glen Allen, VA 23060-6157 | 2009-07-13 |
| 1558464073 | Deborah Josefson | Internal Medicine | 4355 Innslake Drive, Glen Allen, VA 23060 | 2006-09-07 |
| 1104854488 | Randall Morris | Internal Medicine | 10150 Staples Mill Rd, Suite E, Glen Allen, VA 23060-3452 | 2006-06-28 |
| 1992761423 | Springfield Medical Center, P.C. | Internal Medicine | 3970 Springfield Rd, Glen Allen, VA 23060-4119 | 2006-04-24 |
| 1477526507 | Charles W Brandt | Internal Medicine | 4900 Cox Rd, Suite 150, Glen Allen, VA 23060-6295 | 2006-02-09 |
| 1780073924 | Palmetto Long-term Care Coalition | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2015-01-12 |
| 1063799302 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-11-15 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23060 |
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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.