SENTARA MEDICAL GROUP (NPI# 1669923298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669923298 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA NEUROMUSCULAR, AUTONOMIC & MUSIC MEDICINE |
| Practice Address |
600 Gresham Dr Ste 8610 Norfolk VA 23507-1904 |
| Practice Telephone | 7572529015 |
| Practice Fax Number | 7573886106 |
| Mailing Telephone | 7572529015 |
| Mailing Fax Number | 7573886106 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572522765 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0008X |
Psychiatry & Neurology Specialization: Neuromuscular Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sentara Neuromuscular, Autonomic & Music Medicine | Doing Business As Name - Organization |
| 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 |
| 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 |
| Street Address |
600 GRESHAM DR STE 8610 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900515 | Alan C. Harris | Pathology | 600 Gresham Dr, Sentara Norfolk General Hospital Path Dept, Norfolk, VA 23507-1904 | 2005-05-27 |
| 1144834193 | Ana Rosa Vilela Sangay | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-09-06 |
| 1396357901 | Sentara Reference Lab Solutions, LLC | Clinical Medical Laboratory | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-08-17 |
| 1912515610 | Ashley Conner Hihn | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-19 |
| 1396353181 | Levan Gakhokidze | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-17 |
| 1841816022 | Melissa Marie Davis | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-06-23 |
| 1801417506 | Patricia Dickerson | Respiratory Therapist, Registered | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-05-04 |
| 1871112862 | Larry Michael Newton Jr. | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-10 |
| 1710516000 | Emily Carbaugh | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-07 |
| 1700415254 | Lexie Elizabeth Neubauer | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811339237 | Sahawat Tantikittichaikul | Psychiatry & Neurology | 301 N 27th St Ste 12, Norfolk, NE 68701 | 2013-07-26 |
| 1588607089 | Susan Melinda Brown | Psychiatry & Neurology | 301 Riverview Ave Ste 202, Norfolk, VA 23510-1065 | 2006-06-13 |
| 1558793679 | Raymond Gerard Troiano | Psychiatry & Neurology | 600 Gresham Dr, Suite 8630, Sentara Medical Group Neurology, Norfolk, VA 23507-1904 | 2013-07-31 |
| 1881983278 | Bon Secours Depaul Medical Center Inc | Psychiatry & Neurology | 110 Kingsley Ln, Suite 411, Norfolk, VA 23505-4614 | 2011-04-06 |
| 1588806228 | Sara Khorasani | Psychiatry & Neurology | 2700 W Norfolk Ave, Norfolk, NE 68701-4438 | 2009-03-26 |
| 1336393701 | Ingrid Paola Loma-miller | Psychiatry & Neurology | 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 | 2008-11-11 |
| 1982865135 | Hua Wang | Psychiatry & Neurology | 600 Gresham Dr, Suite 8630, Norfolk, VA 23507-1904 | 2008-06-20 |
| 1932369980 | Steven Thomas Kanarek | Psychiatry & Neurology | 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 | 2008-06-12 |
| 1639361033 | Carmen Roxana Fuentes | Psychiatry & Neurology | 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 | 2007-08-10 |
| 1619043551 | Neurology Consultants of Tidewater, Pllc | Psychiatry & Neurology | 6161 Kempsville Cir, Suite 315, Norfolk, VA 23502-3932 | 2006-11-24 |
| 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.