BON SECOURS AMBULATORY SERVICES LLC (NPI# 1740798685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740798685 |
| Entity Type | Organization |
| Organization Name | BON SECOURS AMBULATORY SERVICES LLC |
| Other Organization Name | BON SECOURS TUCKAHOE ORTHOPAEDICS |
| Practice Address |
1501 Maple Ave Ste 200 Richmond VA 23226-2553 |
| Mailing Address |
7229 Forest Ave Ste 112 Richmond VA 23226-3765 |
| Practice Telephone | 8042852300 |
| Practice Fax Number | 8045270250 |
| Mailing Telephone | 8042810275 |
| Mailing Fax Number | 8045219344 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | GEORGE ODELL BUTLER (DIRECTOR CORPORATE RESPONSIBILITY) |
| Authorized Official Telephone | 8042810271 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE PTAN | D347 | 01 |
| Other Name | Type Code |
|---|---|
| Bon Secours Tuckahoe Orthopaedics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346662343 | Bon Secours Ambulatory Services LLC | Clinic/Center | 9851 Brook Rd, Glen Allen, VA 23059-4559 | 2014-01-09 |
| Street Address |
1501 MAPLE AVE STE 200 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23226-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457396913 | Victoria Matt | Specialist | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2006-06-18 |
| 1710486907 | Kelly Mulhern | Physician Assistant | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2018-02-02 |
| 1639695323 | Morgan Toland | Physical Therapist | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2017-08-15 |
| 1861802589 | William Tenpenny | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2014-05-02 |
| 1417375569 | John Taliaferro | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2014-04-04 |
| 1801212428 | Mark Thomas Rose | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226 | 2014-03-06 |
| 1851716914 | Christopher Kester | Specialist | 1501 Maple Ave Ste 200, Richmond, VA 23226 | 2014-02-26 |
| 1871932533 | Jared Smith | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226 | 2013-06-17 |
| 1164785754 | Stephen Edward Watkins | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2012-06-19 |
| 1538474861 | Dustin Chase Dyer | Orthopaedic Surgery | 1501 Maple Ave Ste 200, Richmond, VA 23226-2553 | 2010-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625744 | Eye Surgeons of Richmond, Inc. | Eyewear Supplier (Equipment, not the service) | 5875 Bremo Rd Ste 606, Richmond, VA 23226 | 2017-12-18 |
| 1922517028 | Karen Margaret Karwowski | Physical Therapist | 1901 Charles Street, Crestview Elementary School, Henrico, VA 23226 | 2017-09-21 |
| 1831636463 | Tammy A Lewis | Nurse Practitioner | 5803 Bremo Road, Richmond, VA 23226 | 2017-01-20 |
| 1497116438 | Ashton Williams | Counselor | 2008 Libbie Avenue, Suite 101, Richmond, VA 23226 | 2016-03-18 |
| 1396110078 | Nino Carlo Deleon | Dentist | 5500 Monument Ave Ste G, Richmond, VA 23226 | 2015-12-07 |
| 1083097794 | Amy Michelle Kruger | Podiatrist | 2008 Bremo Rd Ste 100, Richmond, VA 23226 | 2015-06-30 |
| 1841682762 | James Bryce Lothian | Pediatrics | 5875 Bremo Road, Mob South, Suite 303, Pediatric Lung Care, Richmond, VA 23226 | 2015-03-02 |
| 1811334980 | Carmen Wong | Physical Medicine & Rehabilitation | 1901 Libbie Ave, Richmond, VA 23226 | 2013-05-30 |
| 1841533890 | Lauren Etz Freeman | Nurse Practitioner | 7113 Three Chopt Road, Suite 101, Pediatric Associates of Richmond, Inc., Richmond, VA 23226 | 2013-03-28 |
| 1609126044 | Tammy Denise Mills | Nurse Practitioner | 1501 Maple Ave Ste 301, Richmond, VA 23226 | 2012-09-13 |
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| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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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.