SENTARA MEDICAL GROUP


Address: 2790 Godwin Blvd, Suite 225, Suffolk, VA 23434-8151
Phone: 7579344550

SENTARA MEDICAL GROUP (NPI# 1609103902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609103902
Entity Type Organization
Organization Name SENTARA MEDICAL GROUP
Other Organization Name SENTARA INFECTIOUS DISEASE SPECIALIST
Practice Address 2790 Godwin Blvd
Suite 225
Suffolk
VA 23434-8151
Practice Telephone 7579344550
Mailing Telephone 7579344550
Enumeration Date 2009-11-06
Last Update Date 2017-04-04
Authorized Official Name MRS. CINDY A TAYLOR (MANAGER)
Authorized Official Telephone 7572522765
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0200X Internal Medicine
Specialization: Infectious Disease
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA MEDICARE GROUP NUMBER C02033 01

Other Provider/Organization Names

Other Name Type Code
Sentara Infectious Disease Specialist Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 2790 GODWIN BLVD
SUITE 225
City SUFFOLK
State VA
Zip Code 23434-8151

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497757835 Benigno D Federici Obstetrics & Gynecology 2790 Godwin Blvd, Suite 360, Suffolk, VA 23434-8151 2005-08-15
1942757265 Catherine Adickes Registered Nurse 2790 Godwin Blvd, Suite 305, Suffolk, VA 23434-8151 2016-09-02
1568918480 Sentara Medical Group Durable Medical Equipment & Medical Supplies 2790 Godwin Blvd, Ste 355, Suffolk, VA 23434-8151 2016-08-31
1700259520 Virginia Oncology Associates Durable Medical Equipment & Medical Supplies 2790 Godwin Blvd, Suite 101, Suffolk, VA 23434-8151 2015-11-02
1629409156 Sentara Medical Group Otolaryngology 2790 Godwin Blvd, Ste 205, Suffolk, VA 23434-8151 2013-12-10
1780013367 Knox Audiology LLC Audiologist 2790 Godwin Blvd, Suite 205, Suffolk, VA 23434-8151 2013-11-05
1720428865 Jason Rosenwald Physician Assistant 2790 Godwin Blvd, Suite 320, Suffolk, VA 23434-8151 2013-07-03
1093091175 Mary Katherine Williams Advanced Practice Midwife 2790 Godwin Blvd, Suite 360, Suffolk, VA 23434-8153 2011-11-02
1013150457 Sentara Medical Group Psychiatry & Neurology 2790 Godwin Blvd, Suite 235, Suffolk, VA 23434-8151 2009-04-15
1154593176 Theresa G Smith Midwife 2790 Godwin Blvd, Suite 360, Suffolk, VA 23434-8151 2008-03-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235780255 Chiquita Savage Home Health You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 2019-09-20
1912561713 Revivication Counseling Services Counselor 814 Cripple Creek Lane, Suffolk, VA 23434 2019-04-26
1558826958 Nita Jenkins Non-emergency Medical Transport (VAN) 707 Gittings St. Suite 105, Suffolk, VA 23434 2019-02-10
1730660952 Latrese L Riddick Driver 418 Jackson St, Suffolk, VA 23434 2018-08-25
1114411279 Percilla D Zeno Community Health Worker 102 Niblick Cir, Suffolk, VA 23434 2018-06-21
1437652765 Aprele Gaddie Health Educator 2769 Godwin Boulevard, Suffolk, VA 23434 2018-03-13
1598284283 Domonic Teheran Scott Driver 102 Brewer Ave, Suffolk, VA 23434 2017-09-13
1578089397 Nakia Shantel Francis Nurse Practitioner 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 2017-08-15
1679093009 Daisy Mae Aba, LLC Behavioral Analyst 3212 Clearcreek Rd., Suffolk, VA 23434 2017-06-27
1114457736 Better Care Family Homes Day Training, Developmentally Disabled Services 813 West Washington Street, Suffolk, VA 23434 2017-06-15
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Taxonomy Information

Taxonomy Code 207RI0200X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Infectious Disease

Taxonomy Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952812364 Virginia Id Doctors LLC Internal Medicine 4437 Brookfield Corporate Dr Ste 101, Chantilly, VA 20151-2122 2017-10-12
1841749272 Lawrence Daniel Mullany Internal Medicine 12272 Declaration Ave, Chester, VA 23836-3057 2016-09-27
1790172724 Sana Attar Internal Medicine 8220 Meadowbridge Rd Ste 203, Mechanicsville, VA 23116-2339 2015-04-16
1811395205 W. Robert Lange Internal Medicine 835 Gangplank Rd Unit 110, Moneta, VA 24121-2499 2014-12-17
1063835304 Juan Weiss Internal Medicine 9335 Amaryllis Ave., Manassas, VA 20110 2014-01-22
1104165034 Derek Thomas Larson Internal Medicine 133 Green Meadow Dr, Portsmouth, VA 23701-1522 2013-02-13
1023361086 Valerie Riddle Internal Medicine 185 Tara Woods Dr, Bumpass, VA 23024-4934 2012-10-16
1053676858 Mir Akbar Ali Internal Medicine 4720 Puddledock Rd Ste 120, Prince George, VA 23875-1275 2012-07-08
1841560273 Donald Gray Heppner Jr. Internal Medicine 1041 Half Mile Branch Rd, Crozet, VA 22932-3306 2012-01-02
1790075901 Jillian Eileen Raybould Internal Medicine 1000 E Marshall St, Vmi Building, Suite 2015, Richmond, VA 23298-1901 2011-04-10
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Competitor

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City SUFFOLK
Zip Code 23434

Improve Information

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Dataset Information

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.

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