SENTARA MEDICAL GROUP (NPI# 1356523641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356523641 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA VASCULAR SPECIALISTS |
| Practice Address |
3000 Coliseum Dr Ste 200 Hampton VA 23666-5963 |
| Practice Telephone | 7572621110 |
| Practice Fax Number | 7575109116 |
| Mailing Telephone | 7572621110 |
| Mailing Fax Number | 7575109116 |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | MRS. DORIS PRINCE (MANAGER) |
| Authorized Official Telephone | 7572522760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Vascular Specialists | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4000 Coliseum Dr, Ste 310, Hampton, VA 236665906 | 7572621110 | 7575109116 |
| 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 |
3000 COLISEUM DR STE 200 |
| City | HAMPTON |
| State | VA |
| Zip Code | 23666-5963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720052285 | Gregory P Fitzharris | Colon & Rectal Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2006-02-13 |
| 1639684848 | Stacey Harris Tadlock | Nurse Practitioner | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2017-12-11 |
| 1366700684 | Kenneth Sadler Meyers | Surgery | 3000 Coliseum Dr Ste 200, Hampton, VA 23666-5963 | 2012-04-24 |
| 1720055395 | Pragna N Shah | Family Medicine | 3000 Coliseum Dr Ste 200, Hampton, VA 23666 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548824022 | Melanin Excellence Medical Transportation Co LLC | Non-emergency Medical Transport (VAN) | 4418 East Claiborne Sq, Suite 334, Hampton, VA 23666 | 2019-04-30 |
| 1952880502 | Exquisite Counseling Services LLC | Counselor | 2703 Build America Drive, Hampton, VA 23666 | 2018-08-13 |
| 1063999811 | Speak From The Heart | Speech-Language Pathologist | 2 Abbott Dr, Hampton, VA 23666 | 2018-07-24 |
| 1245724632 | Drashti Khamar | Dentist | 2040 Coliseum Dr # A27, Hampton, VA 23666 | 2018-06-19 |
| 1750874772 | Dion J Roszina | Private Vehicle | 806 Charlton,dr, Hampton, VA 23666 | 2018-06-13 |
| 1205352481 | Crystal Lynn Harris | Counselor | 2021 Cunningham Drive, Suite 400, Hampton, VA 23666 | 2017-08-18 |
| 1538693361 | Marquis A. Norton | Counselor | 4410 East Claiborne Street, Suite 334, Hampton, VA 23666 | 2017-04-18 |
| 1194181966 | Key Elements Care, LLC | Case Management | 20 Research Dr Ste 600, Hampton, VA 23666 | 2016-01-11 |
| 1740665215 | Lauren-grey Gonzales Igel | Hearing Instrument Specialist | 1507 Hardy Cash Drive, Hampton, VA 23666 | 2015-07-27 |
| 1457758062 | Alexandra Levine | Acupuncturist | 2216 Executive Dr Ste A, Hampton, VA 23666 | 2014-11-25 |
| Find all providers in zip 23666 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952563728 | Jacquelenn Marie Stuhldreher | Surgery | 3000 Coliseum Dr Ste 100, Hampton, VA 23666-5963 | 2008-07-01 |
| 1356308308 | Michael John Lechman | Surgery | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670930 | Usa Vein Clinics of Chantilly LLC | Surgery | 3914 Centreville Rd Ste 125, Chantilly, VA 20151-3289 | 2019-07-11 |
| 1285115998 | Sentara Medical Group | Surgery | 397 Little Neck Rd Ste 110, Virginia Beach, VA 23452-5774 | 2018-08-22 |
| 1629586417 | Sentara Medical Group | Surgery | 1051 Loftis Blvd Ste 210, Newport News, VA 23606-3069 | 2018-01-16 |
| 1942724620 | Sentara Medical Group | Surgery | 500 Sentara Cir Ste 100, Williamsburg, VA 23188-5727 | 2017-08-03 |
| 1972980761 | Carlos Jose Torres-medina | Surgery | 500 J Clyde Morris Blvd # 603, Newport News, VA 23601-1929 | 2015-04-30 |
| 1306280128 | Justin Marc Milligan | Surgery | 397 Little Neck Rd Ste 120, Virginia Beach, VA 23452-5774 | 2013-04-23 |
| 1578817938 | Clinch Valley Vascular Surgical Assoc., Pllc | Surgery | 6719 Gov. G.c. Peery Highway, Suite 2600, Richlands, VA 24641 | 2012-11-06 |
| 1346503463 | Mid Atlantic Vascular Holding, LLC | Surgery | 1415 Eastridge Rd, Richmond, VA 23229-5501 | 2012-06-22 |
| 1265791297 | Vascular Surgery Group | Surgery | 850 Chistensen Court, Great Falls, VA 22066 | 2012-05-11 |
| 1902122922 | Hao Duy Pham | Surgery | 6719 Governor Gc Peery Hwy Ste 2600, Richlands, VA 24641 | 2010-04-15 |
| Find all providers with the same taxonomy | ||||
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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.