VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY (NPI# 1548317308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548317308 |
| Entity Type | Organization |
| Organization Name | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY |
| Other Organization Name | VCU SPORTS MEDICINE |
| Practice Address |
1300 W Broad St Richmond VA 23284-9089 |
| Mailing Address |
Po Box 758997 Baltimore MD 21275-0001 |
| Practice Telephone | 8048286315 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DOMINIC J PULEO (CFO) |
| Authorized Official Telephone | 8048281295 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | H1875 | VA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM-VCU SPORTS MEDICIN | 180914 | 01 |
| Other Name | Type Code |
|---|---|
| VCU Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164056941 | Virginia Commonwealth University Health System Authority | Clinic/Center | 2495 Pocahontas Trl, Quinton, VA 23141-1637 | 2020-03-02 |
| 1366000473 | Virginia Commonwealth University Health System Authority | Clinic/Center | 607 N 10th St, Richmond, VA 23298-5014 | 2019-06-04 |
| 1972026243 | Virginia Commonwealth University Health System Authority | Pharmacy | 11958 W Broad St Fl 2, Henrico, VA 23233-1007 | 2017-07-19 |
| 1588298368 | Virginia Commonwealth University Health System Authority | Clinic/Center | 2495 Pocahontas Trl, Quinton, VA 23141-1637 | 2020-03-02 |
| 1548821630 | Virginia Commonwealth University Health System Authority | General Acute Care Hospital | 325 Charles H Dimmock Pkwy Ste 100, Colonial Heights, VA 23834-2986 | 2019-06-28 |
| 1720506116 | Virginia Commonwealth University Health System Authority | Pharmacy | 1000 E Broad St, Richmond, VA 23219-1930 | 2017-09-06 |
| 1093238206 | Virginia Commonwealth University Health System Authority | Pharmacy | 1250 E Marshall St, Richmond, VA 23298-5023 | 2017-07-19 |
| 1780033050 | Virginia Commonwealth University Health System Authority | General Acute Care Hospital | 11958 W Broad St, Henrico, VA 23233-1007 | 2016-06-08 |
| 1578940953 | Virginia Commonwealth University Health System Authority | Pharmacy | 401 N 12th St, Richmond, VA 23298-5035 | 2015-05-05 |
| 1497132872 | Virginia Commonwealth University Health System Authority | Pharmacy | 401 N 12th St, Richmond, VA 23298-5035 | 2015-05-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY | 701 E Franklin St Ste 1112, Richmond, VA 23219-2501 |
| Street Address |
1300 W BROAD ST |
| City | RICHMOND |
| State | VA |
| Zip Code | 23284-9089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138101 | Meghan Luczkowski | Physical Therapist | 1300 W Broad St, Richmond, VA 23284-9058 | 2020-09-15 |
| 1477088847 | Jeffrey Michael Collins | Specialist/Technologist | 1300 W Broad St, Richmond, VA 23284-9089 | 2017-04-24 |
| 1891229423 | Ray Kim | Specialist/Technologist | 1300 W Broad St, Richmond, VA 23284-9089 | 2017-04-20 |
| 1861926560 | Mike Avey | Specialist/Technologist | 1300 W Broad St, Richmond, VA 23284-9089 | 2017-04-19 |
| 1538545546 | Emily O'laughlin | Nurse Practitioner | 1300 W Broad St, Suite 2200, Richmond, VA 23284-9089 | 2015-08-03 |
| 1073907135 | Bradly Pruett | Specialist/Technologist | 1300 W Broad St, Richmond, VA 23284-9089 | 2015-03-26 |
| 1336531201 | Laura Parry | Specialist/Technologist | 1300 W Broad St, Suite 130a, Richmond, VA 23284-9089 | 2015-03-02 |
| 1336555226 | Christine Hopkins | Specialist | 1300 W Broad St, Richmond, VA 23284-9089 | 2014-07-11 |
| 1649602657 | Nicole Kiku Stevens | Specialist/Technologist | 1300 W Broad St, Richmond, VA 23284-9089 | 2013-07-31 |
| 1649558255 | Tracy Leigh Arthur | Registered Nurse | 1300 W Broad St, P.o. 842022, Richmond, VA 23284-9089 | 2011-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710495635 | Vanessa M Ellison | Social Worker | 907 Floyd Ave Ste 238, Richmond, VA 23284 | 2018-01-12 |
| 1366786790 | Elizabeth Winthrop | Nurse Practitioner | 1200 W Broad St, Richmond, VA 23284 | 2012-11-26 |
| 1134333099 | Christine Petze Charbonneau | Registered Nurse | 1300 W Broad Street, Virginia Commonwealth University Student Health Service, Richmond, VA 23284 | 2007-05-10 |
| 1174745616 | Virginia Commonweatlh University Student Health Pharmacy | Pharmacy | 1300 W. Broad Street, Suite 2200, Richmond, VA 23284 | 2007-05-03 |
| 1912394800 | Samuel Grodman | Emergency Medicine | 821 W Franklin St, Richmond, VA 23284 | 2015-04-19 |
| 1225242183 | Jeannette Stien Bishai | Registered Nurse | 1300 West Broad Street, Richmond, VA 23284 | 2007-05-10 |
| 1194100644 | James Thomas Benzel | Specialist/Technologist | 1300 West Broad St., Suite 130, Richmond, VA 23284-2003 | 2015-07-27 |
| 1093940447 | Micah L Mccreary | Psychologist | 800 W. Franklin Street, Room 107, Richmond, VA 23284-2018 | 2009-05-28 |
| 1649391376 | Scott E Ross | Specialist/Technologist | 1015 W. Main St, Richmond, VA 23284-2020 | 2007-04-02 |
| 1497873814 | Alan David Freedman | Specialist/Technologist | Virginia Commonwealth University School of Education, 1015 West Main St., Box 842020, Richmond, VA 23284-2020 | 2007-03-26 |
| Find all providers in zip 23284 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346867942 | Henry County Memorial Hospital | Clinic/Center | 4760 National Rd W, Richmond, IN 47374-4745 | 2020-06-30 |
| 1346741667 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Clinic/Center | 12320 W Broad St Ste 100, Richmond, VA 23233 | 2018-02-22 |
| 1003344417 | Healthyway Today LLC | Clinic/Center | 37282 31 Mile Rd, Richmond, MI 48062-1931 | 2017-05-30 |
| 1447500442 | World Ginseng Herb. Co. Inc | Clinic/Center | 3288 Pierce St Ste C 121, Richmond, CA 94804-5960 | 2012-09-17 |
| 1396053740 | Bertram M Brown Od PC | Clinic/Center | 4941 A Nine Mile Road, Richmond, VA 23223-5738 | 2010-09-20 |
| 1073841649 | Pulmonary Assessments | Clinic/Center | 149 West Square Ct, Richmond, VA 23238 | 2009-11-19 |
| 1679619829 | Boardman Family Chiropractic Psc | Clinic/Center | 837 Eastern Byp Ste A, Richmond, KY 40475-3326 | 2007-01-29 |
| 1760579932 | Beth Sholom Rehabilitation Clinic | Clinic/Center | 2700 Lauderdale Dr, Richmond, VA 23238-8110 | 2006-10-06 |
| 1033609862 | Weigh Better Weight Loss, LLC | Clinic/Center | 501 S Keeneland Dr, Richmond, KY 40475 | 2018-05-17 |
| 1629519111 | Health Brigade | Clinic/Center | 1010 N Thompson St, Richmond, VA 23230-4924 | 2017-03-16 |
| 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.