SENTARA MEDICAL GROUP (NPI# 1750689618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750689618 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA PODIATRY SPECIALISTS |
| Practice Address |
5253 Providence Rd Suite 100 Virginia Beach VA 23464-4201 |
| Practice Telephone | 7572524640 |
| Practice Fax Number | 7574956156 |
| Mailing Telephone | 7572524640 |
| Mailing Fax Number | 7574956156 |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572523344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | VA | Suppliers | |
| Y | 213E00000X | Podiatrist | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Podiatry Specialists | 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 |
5253 PROVIDENCE RD SUITE 100 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235123019 | Michael Holtz | Podiatrist | 5253 Providence Rd, Suite 100, Virginia Beach, VA 23464-4201 | 2005-09-07 |
| 1982867057 | Tracy L Klimaz | Podiatrist | 5253 Providence Rd, Suite 100, Virginia Beach, VA 23464-4201 | 2008-07-08 |
| 1760570279 | Virginia Podiatry PC | Podiatrist | 5253 Providence Rd, Suite 100, Virginia Beach, VA 23464 | 2006-10-10 |
| 1164416681 | Michael T Chung | Podiatrist | 5253 Providence Rd, Suite 100, Virginia Beach, VA 23464-4201 | 2005-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245694488 | Kevin David Rabie | Podiatrist | 3720 Holland Rd Ste 100, Virginia Beach, VA 23452-2859 | 2016-04-13 |
| 1992964571 | Pav Pllc | Podiatrist | 936 General Booth Boulevard, Suite A, Virginia Beach, VA 23451-4857 | 2008-06-09 |
| 1912037698 | Podiatry Associates of Virginia PC | Podiatrist | 936a General Booth Blvd, Virginia Beach, VA 23451-4857 | 2007-03-06 |
| 1457447864 | Joseph Giro Smith | Podiatrist | 4620 Bunker Hill Lane, Virginia Beach, VA 23462 | 2006-10-04 |
| 1972569598 | Anthony J. Vuolo Jr. | Podiatrist | 1547 Amberley Forest Rd, Virginia Beach, VA 23453-4706 | 2006-04-22 |
| 1275526501 | Rudolph Clinton Anderson Jr. | Podiatrist | 5241 Princess Anne Rd, #102, Virginia Beach, VA 23462-6310 | 2005-08-23 |
| 1356340798 | Carrie T Cho | Podiatrist | 1232 Perimeter Parkway, Ste. 102, Virginia Beach, VA 23454-5924 | 2005-07-19 |
| 1184897415 | William Zachary Fenn | Podiatrist | 1788 Republic Rd, Suite 300, Virginia Beach, VA 23454-4552 | 2008-04-08 |
| 1285764761 | Jeffrey A Feld | Podiatrist | 936a General Booth Blvd, Podiatry Associates of Virginia, Virginia Beach, VA 23451-4857 | 2007-03-06 |
| 1326175043 | Hampton Roads Family Practice | Podiatrist | 665 Newtown Rd Ste 114, Virginia Beach, VA 23462-1683 | 2007-02-28 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
Please comment or provide details below to improve the information on SENTARA MEDICAL GROUP.
| 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.