BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. (NPI# 1396768453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396768453 |
| Entity Type | Organization |
| Organization Name | BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC. |
| Other Organization Name | ST. MARY'S PEDIATRIC INTENSIVE CARE |
| Practice Address |
5801 Bremo Rd St Mary's Hospital Picu Richmond VA 23226 |
| Mailing Address |
8580 Magellan Pkwy Richmond VA 23227-1149 |
| Practice Telephone | 8042818222 |
| Practice Fax Number | 8042818007 |
| Mailing Fax Number | 8664490896 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | STEPHAN QUIRICONI (CFO) |
| Authorized Official Telephone | 8042818301 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1629096573 | 01 | |
| NPI | 1336161710 | 01 |
| Other Name | Type Code |
|---|---|
| St. Mary's Pediatric Intensive Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194360503 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5899 Bremo Rd Ste 202, Richmond, VA 23226-1935 | 2019-11-08 |
| 1346741667 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100, Richmond, VA 23233 | 2018-02-22 |
| 1215438544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100a, Richmond, VA 23233 | 2018-02-22 |
| 1508388554 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Surgery | 5875 Bremo Rd Ste 110, Richmond, VA 23226-1934 | 2017-07-12 |
| 1255776290 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 2401 W Leigh Street, Richmond, VA 23220-1328 | 2013-05-03 |
| 1639430093 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Psychologist | 5855 Bremo Rd Ste 404, Mob North, Richmond, VA 23226-1924 | 2012-06-01 |
| 1548529126 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Pediatrics | 5855 Bremo Rd Ste 605, Richmond, VA 23226-1926 | 2012-05-16 |
| 1508125386 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 1501 Maple Ave Ste 100, Richmond, VA 23226-2553 | 2012-05-14 |
| 1013280544 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5875 Bremo Rd Ste G11, Mob South, Richmond, VA 23226-1934 | 2012-02-14 |
| 1265736680 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Pediatrics | 5855 Bremo Rd Ste 703, Richmond, VA 23226-1926 | 2010-12-28 |
| Street Address |
5801 BREMO RD ST MARY'S HOSPITAL PICU |
| City | RICHMOND |
| State | VA |
| Zip Code | 23226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346244308 | James L Laham | Pediatrics | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2005-06-08 |
| 1265033443 | Marisa Ferreira | Dietitian, Registered | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2020-11-04 |
| 1720602766 | Rebecca Eades | Nurse Practitioner | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2020-06-05 |
| 1205450228 | Emily Fricker | Nurse Practitioner | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2020-06-05 |
| 1811518053 | Abigail Elizabeth Broadhurst | Occupational Therapist | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2020-04-28 |
| 1720626682 | Amy Marie Fleming Hoyt | Registered Nurse | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2019-12-11 |
| 1699311324 | Hospitalist Medicine Physicians of Virginia - Richmond, LLC | Internal Medicine | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2019-11-18 |
| 1134764616 | Karen Straub | Nurse Practitioner | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2019-11-08 |
| 1952954661 | Nicole Michelle Miller | Nurse Practitioner | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2019-07-22 |
| 1619520806 | Sound Physicians Intensivists of Virginia LLC | Internal Medicine | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2019-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625744 | Eye Surgeons of Richmond, Inc. | Eyewear Supplier (Equipment, not the service) | 5875 Bremo Rd Ste 606, Richmond, VA 23226 | 2017-12-18 |
| 1922517028 | Karen Margaret Karwowski | Physical Therapist | 1901 Charles Street, Crestview Elementary School, Henrico, VA 23226 | 2017-09-21 |
| 1831636463 | Tammy A Lewis | Nurse Practitioner | 5803 Bremo Road, Richmond, VA 23226 | 2017-01-20 |
| 1497116438 | Ashton Williams | Counselor | 2008 Libbie Avenue, Suite 101, Richmond, VA 23226 | 2016-03-18 |
| 1396110078 | Nino Carlo Deleon | Dentist | 5500 Monument Ave Ste G, Richmond, VA 23226 | 2015-12-07 |
| 1083097794 | Amy Michelle Kruger | Podiatrist | 2008 Bremo Rd Ste 100, Richmond, VA 23226 | 2015-06-30 |
| 1841682762 | James Bryce Lothian | Pediatrics | 5875 Bremo Road, Mob South, Suite 303, Pediatric Lung Care, Richmond, VA 23226 | 2015-03-02 |
| 1811334980 | Carmen Wong | Physical Medicine & Rehabilitation | 1901 Libbie Ave, Richmond, VA 23226 | 2013-05-30 |
| 1841533890 | Lauren Etz Freeman | Nurse Practitioner | 7113 Three Chopt Road, Suite 101, Pediatric Associates of Richmond, Inc., Richmond, VA 23226 | 2013-03-28 |
| 1609126044 | Tammy Denise Mills | Nurse Practitioner | 1501 Maple Ave Ste 301, Richmond, VA 23226 | 2012-09-13 |
| Find all providers in zip 23226 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417394370 | Kara D Greenfield | Pediatrics | 1008 E Clay St, Richmond, VA 23298-5056 | 2013-05-31 |
| 1346244308 | James L Laham | Pediatrics | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2005-06-08 |
| 1174049282 | Oliver Laurent Karam | Pediatrics | 1250 E Marshall St, Richmond, VA 23298-5051 | 2017-08-21 |
| 1255750311 | Sunana Singh | Pediatrics | 5801 Bremo Rd, Richmond, VA 23226-1907 | 2014-04-15 |
| 1467711614 | Vu Trieu Nguyen | Pediatrics | 1250 E Marshall St, Richmond, VA 23298-5051 | 2012-05-09 |
| 1265708861 | Michelle Lynn Olson | Pediatrics | 1250 E Marshall St, Richmond, VA 23298-5051 | 2012-03-28 |
| 1821272576 | Alia M Iqbal O'meara | Pediatrics | 1250 E Marshall St, Pediatrics, Richmond, VA 23298-5051 | 2007-12-18 |
| 1588746234 | Jesse C Bain | Pediatrics | 1250 E Marshall St, Pediatrics, Richmond, VA 23298-5051 | 2006-10-20 |
| 1184632671 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Pediatrics | 5801 Bremo Rd, Picu Unit, Richmond, VA 23226-1907 | 2006-08-03 |
| 1174594535 | Norma J Maxvold | Pediatrics | 1250 E Marshall Street, Pediatrics, Richmond, VA 23298-0510 | 2006-02-01 |
| Find all providers in RICHMOND | ||||
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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.