SENTARA MEDICAL GROUP (NPI# 1467720763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467720763 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA SURGERY SPECIALISTS |
| Practice Address |
2075 Glenn Mitchell Dr Ste 512 Virginia Beach VA 23456-0019 |
| Practice Telephone | 7575078850 |
| Mailing Telephone | 7575078850 |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |
| Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572523344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Surgery Specialists | Doing Business As Name - Organization |
| 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 |
2075 GLENN MITCHELL DR STE 512 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23456-0019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639222797 | Melissa J Buchberg | Obstetrics & Gynecology | 2075 Glenn Mitchell Dr, Suite 410, Virginia Beach, VA 23456-0179 | 2007-01-19 |
| 1720530629 | Kelly Graham | Nurse Practitioner | 2075 Glenn Mitchell Dr, Suite 500, Virginia Beach, VA 23456-0179 | 2016-10-26 |
| 1336692524 | Amber Lynn Sourbeer | Physician Assistant | 2075 Glenn Mitchell Dr, Ste 400, Virginia Beach, VA 23456-0179 | 2016-07-25 |
| 1790166692 | Melody Lynne Osborne | Physician Assistant | 2075 Glenn Mitchell Dr, Suite 512, Virginia Beach, VA 23456-0179 | 2015-06-16 |
| 1316284979 | Sentara Medical Group | Surgery | 2075 Glenn Mitchell Dr, Ste 506, Virginia Beach, VA 23456-0179 | 2013-01-15 |
| 1104186428 | Sentara Medical Group | Internal Medicine | 2075 Glenn Mitchell Dr, Ste 400, Virginia Beach, VA 23456-0179 | 2012-05-21 |
| 1619251089 | Sentara Medical Group | Surgery | 2075 Glenn Mitchell Dr, Ste 512a, Virginia Beach, VA 23456-0019 | 2011-10-04 |
| 1366774192 | Susan Edmondson Phillips | Genetic Counselor, MS | 2075 Glenn Mitchell Dr, Suite 500, Virginia Beach, VA 23456-0179 | 2010-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336679349 | Joelene Grandy | Contractor | 1892 Riverrock Arch, Virginia Beach, VA 23456 | 2017-06-13 |
| 1023568995 | Red Mill Pediatric Dentistry and Behl Orthodontics Pllc | Dentist | 2033 Fisher Arch, Ste 100, Virginia Beach, VA 23456 | 2016-10-04 |
| 1609235803 | Maria Teresa Olivas | Registered Nurse | 3212 Fluuanna Circle, Virginia Beach, VA 23456 | 2016-02-16 |
| 1326434747 | Catharine White Cartwright | Physician Assistant | 2501 James Madison Blvd, Virginia Beach, VA 23456 | 2015-04-13 |
| 1598153785 | Harris Teeter LLC | Pharmacy | 2105 Princess Anne Road, Suite 100, Virginia Beach, VA 23456 | 2014-12-23 |
| 1881034023 | Kimberly Ann Benson | Dentist | 2105 Princess Anne Road, Suite 108, Virginia Beach, VA 23456 | 2013-07-02 |
| 1124378450 | Phyllis A. Wilson | Psychologist | 1249 Eagle Way, Virginia Beach, VA 23456 | 2012-09-13 |
| 1033477807 | Wolfgang J. Bay | Dentist | 1625 Salem Road #101, Virginia Beach, VA 23456 | 2012-04-30 |
| 1881974475 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2232 General Booth Blvd, Virginia Beach, VA 23456 | 2011-08-26 |
| 1780988857 | Casey Snyder | Dentist | 2484 North Landing Road, Virginia Beach, VA 23456 | 2011-01-05 |
| Find all providers in zip 23456 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1851662654 | John P Clarke | Surgery | 1297 Holly Point Rd, Virginia Beach, VA 23454-1932 | 2012-01-25 |
| 1710210885 | George Charles Wilson | Surgery | 2901 S Lynnhaven Rd, Suite 170, Virginia Beach, VA 23452-8505 | 2009-09-08 |
| 1396906244 | Stephanie Michelle Sims | Surgery | 1120 First Colonial Rd Ste 203, Virginia Beach, VA 23454-2418 | 2008-06-24 |
| 1306045570 | Donald D Jenkins | Surgery | 1080 First Colonial Rd Ste 200, Virginia Beach, VA 23454-2406 | 2007-07-17 |
| 1093752354 | Laurence William Enderson IIi | Surgery | 840 First Colonial Rd, Suite 102, Virginia Beach, VA 23451-6106 | 2006-06-02 |
| 1376599316 | Ricardo Moscoso | Surgery | 100 Constitution Dr Ste 217, Virginia Beach, VA 23462-6799 | 2006-05-25 |
| 1902854540 | Leanelle Goldstein | Surgery | Virginia Beach General Hospital, First Colonial Road, Virginia Beach, VA 23454 | 2006-05-05 |
| 1497739619 | Martin G Ogrady | Surgery | 329 Phillip Ave, Ste 102, Virginia Beach, VA 23454-4461 | 2005-12-01 |
| 1487638623 | Joseph M Dalton | Surgery | 1020 First Colonial Rd, Virginia Beach, VA 23454-3002 | 2005-12-01 |
| 1871588145 | Juni A. Femi-pearse | Surgery | 5484 Memorial Dr, Virginia Beach, VA 23455-3782 | 2005-09-13 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23456 |
Please comment or provide details below to improve the information on SENTARA MEDICAL GROUP.
| 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.