BON SECOURS DEPAUL MEDICAL CENTER (NPI# 1548520315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548520315 |
| Entity Type | Organization |
| Organization Name | BON SECOURS DEPAUL MEDICAL CENTER |
| Other Organization Name | DEPAUL/EVMS OTOLARYNGOLOGY HEAD AND NECK SURGERY |
| Practice Address |
100 Kingsley Ln Suite 404 Norfolk VA 23505-4604 |
| Practice Telephone | 7578895632 |
| Practice Fax Number | 7578895633 |
| Mailing Telephone | 7578895632 |
| Mailing Fax Number | 7578895633 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-06-26 |
| Authorized Official Name | MICHAEL K KERNER (CEO) |
| Authorized Official Telephone | 7576735929 |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS DEPAUL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| DePaul/EVMS Otolaryngology Head and Neck Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336520618 | Bon Secours Depaul Medical Center | Family Medicine | 309 Battlefield Blvd S, Chesapeake, VA 23322-5311 | 2015-06-12 |
| 1740618412 | Bon Secours Depaul Medical Center | Internal Medicine | 400 Gresham Dr, Suite 808, Norfolk, VA 23507-1901 | 2013-10-16 |
| 1619251337 | Bon Secours Depaul Medical Center | Family Medicine | 1020 Independence Blvd, Suite 305, Virginia Beach, VA 23455-5500 | 2011-09-29 |
| 1366725160 | Bon Secours Depaul Medical Center | Internal Medicine | 1020 Independence Blvd, Sutie 206, Virginia Beach, VA 23455-5500 | 2011-09-28 |
| 1669779252 | Bon Secours Depaul Medical Center | Pain Medicine | 4445 Corporation Ln, Suite 120, Virginia Beach, VA 23462-3262 | 2011-02-17 |
| 1881998771 | Bon Secours Depaul Medical Center | Internal Medicine | 142 W York St, Suite 508, Norfolk, VA 23510-2015 | 2011-01-06 |
| 1457505711 | Bon Secours Depaul Medical Center | Internal Medicine | 5301 Providence Rd, Suite 90, Virginia Beach, VA 23464-4128 | 2008-11-12 |
| 1316119332 | Bon Secours Depaul Medical Center | Internal Medicine | 6161 Kempsville Cir, Suite 335, Norfolk, VA 23502-3932 | 2008-03-31 |
| 1326181413 | Bon Secours Depaul Medical Center | Plastic Surgery | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2007-02-15 |
| Street Address |
100 KINGSLEY LN SUITE 404 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275524563 | Houssam Addin Quraid | Specialist/Technologist, Other | 100 Kingsley Ln, Suite 302, Norfolk, VA 23505-4604 | 2005-11-04 |
| 1275089377 | Leanne J Veary | Physician Assistant | 100 Kingsley Ln, Suite 400, Norfolk, VA 23505-4604 | 2016-08-29 |
| 1386023091 | Amanda Marie Townsend | Physician Assistant | 100 Kingsley Ln, Suite 400, Norfolk, VA 23505-4604 | 2015-05-27 |
| 1245648559 | April Joan Harvill | Physician Assistant | 100 Kingsley Ln, Norfolk, VA 23505-4604 | 2014-07-30 |
| 1659797181 | Mid-atlantic Womens Care, Plc | Obstetrics & Gynecology | 100 Kingsley Ln, Suite 100, Norfolk, VA 23505-4604 | 2014-03-07 |
| 1376845255 | Krystle Rita Lappinen | Obstetrics & Gynecology | 100 Kingsley Ln, Suite 400, Norfolk, VA 23505-4604 | 2010-11-25 |
| 1639318843 | Howard O Goodwin | Nurse Anesthetist, Certified Registered | 100 Kingsley Ln, Norfolk, VA 23505-4604 | 2009-02-11 |
| 1659533057 | Angela W Parson | Obstetrics & Gynecology | 100 Kingsley Ln, Suite 100, Norfolk, VA 23505-4604 | 2008-06-26 |
| 1295915809 | Sentara Medical Group | Urology | 100 Kingsley Ln, Ste 404, Norfolk, VA 23505-4604 | 2007-11-12 |
| 1952503161 | Guy Trengove-jones | Plastic Surgery | 100 Kingsley Ln, Suite 302, Norfolk, VA 23505-4604 | 2007-06-01 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 23505 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326535410 | Healing Hands of Nebraska, PC | Otolaryngology | Sunset Plaza, 1700 Market Lane, Suite 410, Norfolk, NE 68701 | 2018-04-16 |
| 1376503391 | Demetrio Juan Aguila IIi | Otolaryngology | 1700 Market Ln Ste 410, Norfolk, NE 68701 | 2006-03-24 |
| 1154391829 | Ashley Anders Schroeder | Otolaryngology | 600 Gresham Dr Ste 1100, Evms Medical Group, Norfolk, VA 23507-1904 | 2006-01-25 |
| 1700887239 | John Kalafsky | Otolaryngology | 901 Hampton Blvd, Norfolk, VA 23507-1503 | 2005-08-09 |
| 1437538154 | Ear, Nose & Throat Ltd | Otolaryngology | 901 Hampton Blvd, Norfolk, VA 23507-1503 | 2015-05-27 |
| 1144563529 | Benjamin Joseph Rubinstein | Otolaryngology | 600 Gresham Dr Ste 1100, Norfolk, VA 23507-1904 | 2013-04-03 |
| 1407176811 | Kent Kwok Kin Lam | Otolaryngology | 600 Gresham Dr Ste 1100, Norfolk, VA 23507-1904 | 2010-06-08 |
| 1881849115 | Vivian F Wu | Otolaryngology | 600 Gresham Dr, Suite 1100, Norfolk, VA 23507-1904 | 2008-12-01 |
| 1922219435 | Cristina Marie Baldassari | Otolaryngology | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2007-05-25 |
| 1760577985 | Joseph Khristian Han | Otolaryngology | 600 Gresham Dr, Suite 1100, Norfolk, VA 23507-1904 | 2006-10-04 |
| Find all providers in NORFOLK | ||||
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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.