BON SECOURS DEPAUL MEDICAL CENTER INC (NPI# 1598998569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598998569 |
| Entity Type | Organization |
| Organization Name | BON SECOURS DEPAUL MEDICAL CENTER INC |
| Other Organization Name | BON SECOURS SURGICAL SPECIALISTS |
| Practice Address |
155 Kingsley Ln Ste 405 Norfolk VA 23505-4629 |
| Mailing Address |
8580 Magellan Pkwy Richmond VA 23227-1149 |
| Practice Telephone | 7572782220 |
| Practice Fax Number | 7574890701 |
| Mailing Telephone | 8046275462 |
| Mailing Fax Number | 8664490896 |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2019-05-16 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bon Secours Surgical Specialists | Doing Business As Name - Organization |
| Bon Secours Surgical Specialists @DMC | 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 |
| 1437525359 | Bon Secours Depaul Medical Center Inc | General Acute Care Hospital | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2015-08-14 |
| 1144630450 | Bon Secours Depaul Medical Center Inc | Family Medicine | 4421 Virginia Beach Blvd Ste 114, Virginia Beach, VA 23462-3114 | 2014-05-08 |
| Street Address |
155 KINGSLEY LN STE 405 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-4629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164683009 | Stephanie K Repole | Surgery | 155 Kingsley Ln Ste 405, Norfolk, VA 23505-4629 | 2008-06-23 |
| 1972012565 | Talisha Devon Anderson | Nurse Practitioner | 155 Kingsley Ln Ste 405, Norfolk, VA 23505-4629 | 2017-09-26 |
| 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 | 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 |
|---|---|---|---|---|
| 1255728374 | Malinda Lyon | Surgery | 8150 Shore Drive, #522, Norfolk, VA 23518 | 2015-04-16 |
| 1336567601 | Ryan Carver | Surgery | 880 Kempsville Rd Ste 1000, Norfolk, VA 23502-3978 | 2014-04-02 |
| 1891052676 | Conor Francis Hynes | Surgery | 1530 Gilbert St Ste 2000, Norfolk, VA 23511 | 2012-04-18 |
| 1871867747 | Brian Joseph Kennerley | Surgery | U. S. Marine Corps Forces Command, 1775 Forrestal Drive Bldg 33, Norfolk, VA 23511 | 2012-02-23 |
| 1144590779 | Edward Albert Pollard | Surgery | 17 Lois Ln, Norfolk, MA 02056-1823 | 2012-01-12 |
| 1164683009 | Stephanie K Repole | Surgery | 155 Kingsley Ln Ste 405, Norfolk, VA 23505-4629 | 2008-06-23 |
| 1639277544 | Alan Harvey Jaffe | Surgery | 160 Kingsley Ln Ste 205, Norfolk, VA 23505-4600 | 2006-09-21 |
| 1437169042 | Venkat Manoranjan Reddy | Surgery | 400 Gresham Drive, Suite 308, Norfolk, VA 23507 | 2006-08-08 |
| 1114931938 | Thomas M Beutler | Surgery | 301 N 27th St, Suite 1, Norfolk, NE 68701-4457 | 2006-07-28 |
| 1699731901 | Andrew Y Reynolds | Surgery | 301 N 27th St Ste 8, Norfolk, NE 68701-4457 | 2006-04-25 |
| 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.