BON SECOURS DEPAUL MEDICAL CENTER INC (NPI# 1437525359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437525359 |
| Entity Type | Organization |
| Organization Name | BON SECOURS DEPAUL MEDICAL CENTER INC |
| Other Organization Name | BON SECOURS DEPAUL MEDICAL CENTER PRO FEE |
| Practice Address |
150 Kingsley Ln Norfolk VA 23505-4602 |
| Mailing Address |
8580 Magellan Pkwy Richmond VA 23227-1149 |
| Practice Telephone | 7573982208 |
| Practice Fax Number | 7573982004 |
| Mailing Fax Number | 8664490896 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2019-08-30 |
| Authorized Official Name | STEPHAN QUIRICONI (CFO) |
| Authorized Official Telephone | 8042818301 |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS DEPAUL MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 490011 | VA | Hospitals |
| Other Name | Type Code |
|---|---|
| Bon Secours DePaul Medical Center pro fee | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124438437 | Bon Secours Depaul Medical Center Inc | Family Medicine | 4211 Monarch Way, Norfolk, VA 23508-2540 | 2014-05-08 |
| 1205246519 | Bon Secours Depaul Medical Center Inc | Physical Medicine & Rehabilitation | 908 Eden Way N Ste 100, Chesapeake, VA 23320-3336 | 2014-05-08 |
| 1396172219 | Bon Secours Depaul Medical Center Inc | Family Medicine | 4241 E Little Creek Rd, Norfolk, VA 23518-3546 | 2013-10-09 |
| 1245467521 | Bon Secours Depaul Medical Center Inc | Obstetrics & Gynecology | 100 Kingsley Ln Ste 100, Norfolk, VA 23505-4604 | 2009-06-15 |
| 1316182835 | Bon Secours Depaul Medical Center Inc | Internal Medicine | 100 Kingsley Ln Ste 400, Norfolk, VA 23505-4604 | 2008-12-12 |
| 1154521854 | Bon Secours Depaul Medical Center Inc | Internal Medicine | 828 Healthy Way Ste 220, Virginia Beach, VA 23462-7960 | 2007-07-20 |
| 1922202571 | Bon Secours Depaul Medical Center Inc | Family Medicine | 4421 Virginia Beach Blvd Ste 114, Virginia Beach, VA 23462-3114 | 2007-06-14 |
| 1215494380 | Bon Secours Depaul Medical Center Inc | Surgery | 930 W 21st St Ste 100, Norfolk, VA 23517-1516 | 2019-02-26 |
| 1144630450 | Bon Secours Depaul Medical Center Inc | Family Medicine | 4421 Virginia Beach Blvd Ste 114, Virginia Beach, VA 23462-3114 | 2014-05-08 |
| 1073955001 | Bon Secours Depaul Medical Center Inc | Radiology | 155 Kingsley Ln Ste 100, Norfolk, VA 23505-4630 | 2013-07-18 |
| Street Address |
150 KINGSLEY LN |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003812785 | Patrick B. Higdon | Family Medicine | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2005-06-27 |
| 1497385033 | Jennifer L Lemasters-stover | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2020-01-23 |
| 1356813083 | Sarah West Taylor | Clinical Nurse Specialist | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-12-19 |
| 1619443009 | Amarachi G Agbai | Registered Nurse | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-10-23 |
| 1043795867 | Lindsey Reprogle | Physician Assistant | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-09-27 |
| 1528549219 | Chika I Ogbolu | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-08-22 |
| 1457846024 | Gia Martin | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-06-26 |
| 1295237477 | Shannon Coulson | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-03-05 |
| 1053834960 | Kathryn Alise Gale | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2017-07-23 |
| 1881139434 | Corinna Brander | Nurse Practitioner | 150 Kingsley Ln, Neuroscience Office, Norfolk, VA 23505-4602 | 2017-01-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154844256 | Cassandra Shelton | Specialist/Technologist, Other | 100 Kingsley Lane, Norfolk, VA 23505 | 2017-07-20 |
| 1063942852 | Gabriela Marie Santiago | Specialist/Technologist | 7600 Victory Dr, Apt 3, Norfolk, VA 23505 | 2017-06-14 |
| 1144776725 | Amr Hassan | Pharmacist | 1610 W Little Creek Rd, Apt 204, Norfolk, VA 23505 | 2016-09-01 |
| 1992175095 | Heather Mitchell | Nurse Practitioner | 110 Kingsley Ln Ste 309, Norfolk, VA 23505 | 2015-10-01 |
| 1255710620 | Jessica Ann Kestranek | Dentist | 7400 Granby St Ste D, Norfolk, VA 23505 | 2015-05-19 |
| 1710375274 | Carla Toledo | Nurse Practitioner | 155 Kingsley Lane, Suite 400, Norfolk, VA 23505 | 2015-01-06 |
| 1417359746 | James Austin Valone Jr. | Ophthalmology | 1423 Runymede Rd, Norfolk, VA 23505 | 2014-09-18 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1649549361 | Linda Horsey | Social Worker | 7510 Granby Street, Suite 6, Norfolk, VA 23505 | 2011-12-27 |
| 1679705164 | Carolyn Lee Kee | Nurse's Aide | 7403 Hampton Blvd, Norfolk, VA 23505 | 2009-08-17 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578940268 | Eastern Virginia Medical School | General Acute Care Hospital | 714 Woodis Ave, Norfolk, VA 23510-1026 | 2015-05-01 |
| 1689076721 | Stephen Mcginley | General Acute Care Hospital | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2014-09-19 |
| 1588005177 | Sentara Hospital Medicine Physicians | General Acute Care Hospital | 600 Gresham Dr, Raleigh Building 3rd Floor, Norfolk, VA 23507-1904 | 2013-07-11 |
| 1962846188 | East Virginia Medical School | General Acute Care Hospital | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2013-04-18 |
| 1215024617 | Sentara Hospitals | General Acute Care Hospital | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2006-10-06 |
| 1134137615 | Bon Secours Depaul Medical Center LLC | General Acute Care Hospital | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2006-08-03 |
| 1811957681 | Sentara Hospitals | General Acute Care Hospital | 830 Kempsville Rd, Norfolk, VA 23502-3920 | 2006-03-24 |
| 1437119310 | Sentara Hospitals | General Acute Care Hospital | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538669445 | Virginia Hospital Center Arlington Health System | General Acute Care Hospital | 8100 Boone Blvd Ste 140, Vienna, VA 22182-2665 | 2018-02-16 |
| 1871020651 | Virginia Internal Medicine Specialists LLC | General Acute Care Hospital | 44790 Maynard Sq Ste 320, Ashburn, VA 20147-6514 | 2017-05-11 |
| 1730615816 | Sentara Healthcare | General Acute Care Hospital | 100 Ireland St, Hampton, VA 23663-2150 | 2017-05-10 |
| 1528592573 | New York Presbyterian Hospital-weill Cornell | General Acute Care Hospital | 9644 Sutton Green Ct, Vienna, VA 22181-6105 | 2017-04-17 |
| 1386181733 | Lyle Purnell | General Acute Care Hospital | 100 Emancipation Dr Bldg 146, Hampton, VA 23667-0001 | 2017-01-24 |
| 1700233855 | Debra Hafer | General Acute Care Hospital | 33290 Chincoteague Rd, Wallops Island, VA 23337-2204 | 2016-05-18 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1700248796 | Hq Surgical | General Acute Care Hospital | 905 Hathaway Ct, Chesapeake, VA 23322-7622 | 2016-03-28 |
| 1710355649 | Johnston Memorial Hospital, Inc | General Acute Care Hospital | 3175 Linden Dr Ste 3-5, Bristol, VA 24202-5849 | 2015-09-09 |
| 1184092298 | Anita Sites | General Acute Care Hospital | Uva Transplant Center 1300 Jefferson Park Ave Fl 4, Charlottesville, VA 22908-3363 | 2015-09-04 |
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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.