DOMINION HEALTH MEDICAL ASSOC (NPI# 1639457179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639457179 |
| Entity Type | Organization |
| Organization Name | DOMINION HEALTH MEDICAL ASSOC |
| Other Organization Name | SENTARA HALIFAX ANESTHESIOLOG |
| Practice Address |
2204 Wilborn Ave South Boston VA 24592 |
| Mailing Address |
P.o. Box 860 South Boston VA 24592 |
| Practice Telephone | 4345173999 |
| Practice Fax Number | 4345173887 |
| Mailing Telephone | 4345173513 |
| Mailing Fax Number | 4345173887 |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2015-02-10 |
| Authorized Official Name | CECIL HAZELWOOD (MANAGER SDHG) |
| Authorized Official Telephone | 4345173515 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sentara Halifax Anesthesiolog | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1669572897 | Dominion Health Medical Assoc | Legal Medicine | 115 College St, Clarksville, VA 23927 | 2006-09-25 |
| 1689772238 | Dominion Health Medical Assoc | Legal Medicine | 946 N. Main St, Chase City, VA 23924 | 2006-09-20 |
| 1568933182 | Dominion Health Medical Assoc | Clinic/Center | 101 Aubreys Loop, South Boston, VA 24592-5054 | 2018-12-07 |
| 1457756322 | Dominion Health Medical Assoc | Pediatrics | 101 Aubreys Loop, South Boston, VA 24592-5054 | 2014-11-04 |
| 1427306315 | Dominion Health Medical Assoc | Specialist | 2232 Wilborn Ave, Suite F, South Boston, VA 24592 | 2012-08-27 |
| 1760740625 | Dominion Health Medical Assoc | Clinic/Center | 2206 Wilborn Ave, South Boston, VA 24592 | 2012-04-30 |
| 1134407570 | Dominion Health Medical Assoc | Clinic/Center | 2204 Wilborn Ave, South Boston, VA 24592 | 2011-08-03 |
| 1598928277 | Dominion Health Medical Assoc | Legal Medicine | 2232 Wilborn Ave, Suite C, South Boston, VA 24592 | 2008-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DOMINION HEALTH MEDICAL ASSOCIATES LTD. | 2204 Wilborn Ave, South Boston, Virginia 24592 |
| Street Address |
2204 WILBORN AVE |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668842 | Halifax Regional Hospital, Inc. | General Acute Care Hospital | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2005-06-02 |
| 1871058008 | Angeline Marie Davis | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2019-02-01 |
| 1063931897 | Jon Michael Hughes | Nurse Practitioner | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-13 |
| 1265950646 | Mara Olivia Fiorio | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-09-06 |
| 1942745526 | Alisyn L. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1255876835 | Andrew D. Metz | Nurse Anesthetist, Certified Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2017-01-05 |
| 1942743398 | Melaku Akele | Physical Therapist | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-12-01 |
| 1740730316 | Emily Silsby | Dietitian, Registered | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-10-07 |
| 1023567153 | Mulbriar Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-09-30 |
| 1205381621 | Banister River Emergency Physicians LLC | Physician Assistant | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2016-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417985664 | Gregory Alan Shuford | Anesthesiology | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2006-06-28 |
| 1548215643 | Ming Y. Liu | Anesthesiology | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2006-05-24 |
| 1306899406 | Hector Marquez | Anesthesiology | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2006-05-18 |
| 1881645471 | Cesar A Souza | Anesthesiology | 2204 Wilborn Ave, South Boston, VA 24592-1645 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573534 | Dulles Pain & Functional Medicine | Anesthesiology | 20 Pidgeon Hill Dr Ste 205, Sterling, VA 20165-6134 | 2020-09-16 |
| 1306473491 | Metropolitan Anesthesia Consultants, Pllc | Anesthesiology | 1219 Chadsworth Ct, Mc Lean, VA 22102-2319 | 2020-03-26 |
| 1174164578 | Bon Secours Medical Group Hampton Roads Specialty Care LLC | Anesthesiology | 3640 High St Ste 1f, Portsmouth, VA 23707-3213 | 2019-10-07 |
| 1487203998 | Christine Joyce Hanson | Anesthesiology | 11512 Gordon Rd, Fredericksburg, VA 22407-1775 | 2019-09-06 |
| 1962976043 | The Devana Group LLC | Anesthesiology | 17739 Main St Ste 110, Dumfries, VA 22026-3256 | 2019-01-11 |
| 1588175970 | Louisa Catherine Korte | Anesthesiology | 3107 Summerhouse Drive, Suffolk, VA 23435 | 2017-10-12 |
| 1093231979 | Gapc Anesthesia, LLC | Anesthesiology | 7915 Lake Manassas Dr Ste 302, Gainesville, VA 20155-3260 | 2017-08-22 |
| 1427574581 | Pars Anesthesia Associates, Pllc | Anesthesiology | 2280 Opitz Blvd Ste 200, Woodbridge, VA 22191-3330 | 2017-08-20 |
| 1205367240 | One Anesthesia of Virginia, PC | Anesthesiology | 480 Labrador Ln, Charlottesville, VA 22903-7229 | 2017-03-22 |
| 1457882649 | Capital Anesthesia Associates LLC | Anesthesiology | 746 Walker Rd, Ste 16-d, Great Falls, VA 22066-2643 | 2017-03-21 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
Please comment or provide details below to improve the information on DOMINION HEALTH MEDICAL ASSOC.
| 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.