DR. WENDELL T POULSEN JR. (NPI# 1457326811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457326811 |
| Entity Type | Individual |
| Full Name | DR. WENDELL T POULSEN JR. |
| Credential | M.D. |
| Practice Address |
5659 Parkway Dr Ste 100 Gloucester VA 23061-3792 |
| Practice Telephone | 8042101005 |
| Practice Fax Number | 8042101009 |
| Mailing Telephone | 8042101005 |
| Mailing Fax Number | 8042101009 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2012-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 0101031371 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010156041 | 05 |
| Street Address |
5659 PARKWAY DR STE 100 |
| City | GLOUCESTER |
| State | VA |
| Zip Code | 23061-3792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625710 | Velocity Urgent Care, LLC | Clinic/Center | 5659 Parkway Dr, Gloucester, VA 23061-3792 | 2017-12-18 |
| 1710377742 | Sentara Medical Group | Internal Medicine | 5659 Parkway Dr, Ste 220, Gloucester, VA 23061-3792 | 2015-01-29 |
| 1235536426 | Sentara Medical Group | Internal Medicine | 5659 Parkway Dr, Ste 200, Gloucester, VA 23061-3792 | 2014-12-03 |
| 1659655744 | Sentara Medical Group | Surgery | 5659 Parkway Dr, Ste 200, Gloucester, VA 23061-3792 | 2011-10-06 |
| 1750680633 | Sentara Medical Group | Clinic/Center | 5659 Parkway Dr, Suite 100, Gloucester, VA 23061-3792 | 2011-03-18 |
| 1205168143 | Sentara Medical Grou P | Surgery | 5659 Parkway Dr, Suite 210a, Gloucester, VA 23061-3792 | 2010-02-03 |
| 1457683393 | Sentara Medical Group | Surgery | 5659 Parkway Dr, Suite 210b, Gloucester, VA 23061-3792 | 2010-02-03 |
| 1295969962 | Sentara Medical Group | Pediatrics | 5659 Parkway Dr, Suite 230, Gloucester, VA 23061-3782 | 2009-05-11 |
| 1851538201 | Sentara Medical Group | Pediatrics | 5659 Parkway Dr, Ste 230, Gloucester, VA 23061-3782 | 2009-01-07 |
| 1205086071 | Daniel E Pouchot, Dds, Pllc | Dentist | 5659 Parkway Dr, Suite 140, Gloucester, VA 23061-3782 | 2008-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770087546 | Connex Family Services | Behavioral Analyst | 6948 Main Street Ste. 12, Gloucester, VA 23061 | 2018-03-19 |
| 1699278820 | Blake Steagall | Counselor | 7296 York Avenue, Gloucester, VA 23061 | 2018-03-14 |
| 1982103941 | Cathyrn Fields Radford | Speech-Language Pathologist | Page Middle School, 5198 T. C. Walker Road, Gloucester, VA 23061 | 2018-02-06 |
| 1326558727 | Home Care Associates LLC | Technician | 6812 Teagle Lane, Unit 1, Gloucester, VA 23061 | 2017-10-11 |
| 1154847176 | Thorpe Counseling Center | Social Worker | 6486 Main Street, Suite 10, Gloucester, VA 23061 | 2017-08-22 |
| 1215473715 | Christina Vickers | Prevention Professional | 7824 Windy Hill Road, Gloucester, VA 23061 | 2017-01-09 |
| 1487084372 | Debra Leigh Ottarson | Pharmacist | 6634 Jarvis Road, Gloucester, VA 23061 | 2013-11-14 |
| 1114170446 | Riverside Physician Services Inc | Psychiatry & Neurology | 7547 Medial Drive, Suite 1300, Gloucester, VA 23061 | 2008-10-30 |
| 1881846087 | Nine Palms 1, LLC | Home Health | 6606 Main St, Gloucester, VA 23061 | 2008-10-21 |
| 1396909867 | Sandra B Buchheister | Physical Therapist | 6965 Fox Hunt Lane, Suite 201, Gloucester, VA 23061 | 2008-07-15 |
| Find all providers in zip 23061 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275740557 | Richard Riddick Honablue Jr. | Family Medicine | 8025 Belroi Rd, Gloucester, VA 23061-4300 | 2007-05-17 |
| 1649336322 | Richard J. Sagall | Family Medicine | 120 Western Ave, Gloucester, MA 01930-4036 | 2006-12-28 |
| 1235226176 | Francis Thornton West IIi | Family Medicine | 6506 Main Street, Gloucester, VA 23061 | 2006-10-10 |
| 1174639678 | Robert E Slocum | Family Medicine | 302 Washington Street Gloucester Family Health Center, Gloucester, MA 01930-3876 | 2006-08-21 |
| 1013022797 | Yuliya P Mandel | Family Medicine | 298 Washington St Fl 4, Gloucester, MA 01930-4832 | 2006-08-20 |
| 1316985419 | Barry Giglio | Family Medicine | 35 Dory Rd, Gloucester, MA 01930-2236 | 2006-06-02 |
| 1255378360 | Edward Leslie Lundy | Family Medicine | 1017 Market St, Gloucester, NJ 08030-1847 | 2006-05-31 |
| 1720047558 | Virginia L Herbert | Family Medicine | 7554 Hospital Dr Ste D-303, Gloucester, VA 23061-4178 | 2006-03-21 |
| 1619965654 | Kathryn Joan Hollett | Family Medicine | Lahey Health Primary Care, Gloucester, 298 Washington Street, Gloucester, MA 01930 | 2005-10-13 |
| 1245570795 | Courthouse Family Medicine, Pllc | Family Medicine | 6760 Main St, Gloucester, VA 23061-5143 | 2013-02-20 |
| Find all providers in GLOUCESTER | ||||
| City | GLOUCESTER |
| Zip Code | 23061 |
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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.