SOUTHERN SURGICAL ASSOCIATES LLC (NPI# 1790715506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790715506 |
| Entity Type | Organization |
| Organization Name | SOUTHERN SURGICAL ASSOCIATES LLC |
| Other Organization Name | COMMONWEALTH SURGICAL ASSOCIATES |
| Practice Address |
3640 High St Suite 2f Portsmouth VA 23707-3213 |
| Practice Telephone | 7573972383 |
| Practice Fax Number | 7573975201 |
| Mailing Telephone | 7573972383 |
| Mailing Fax Number | 7573975201 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2008-01-14 |
| Authorized Official Name | DR. VASKEN KEVORK TENEKJIAN (PRESIDENT) |
| Authorized Official Telephone | 7573972383 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C05853 | 01 |
| Other Name | Type Code |
|---|---|
| Commonwealth Surgical Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619026713 | Southern Surgical Associates LLC | Surgery | 1060 Fairfax Park, Suite B, Tuscaloosa, AL 35406 | 2007-01-09 |
| Street Address |
3640 HIGH ST SUITE 2F |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23707-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336147719 | Jeffrey Lynn Riblet | Surgery | 3640 High St, Suite 2f, Portsmouth, VA 23707-3213 | 2005-07-11 |
| 1114440484 | Juanita Parker | Nurse Practitioner | 3640 High St, Portsmouth, VA 23707-3213 | 2017-07-19 |
| 1740726199 | Danielle Bibeault | Nurse Practitioner | 3640 High St, Suite 1a, Portsmouth, VA 23707 | 2017-01-10 |
| 1639620057 | Sarah Anderson | Nurse Practitioner | 3640 High St, Suite 2-f, Portsmouth, VA 23707-3213 | 2016-10-20 |
| 1245539998 | Stephanie Brashear | Family Medicine | 3640 High St, Portsmouth, VA 23707 | 2011-03-21 |
| 1740588425 | Foot & Ankle Medical Center, LLC | Podiatrist | 3640 High St, Suite D1, Portsmouth, VA 23707-3213 | 2011-03-04 |
| 1922300490 | Sarah R Darrow | Registered Nurse | 3640 High St, Suite 3b, Portsmouth, VA 23707-3213 | 2010-12-03 |
| 1407021397 | Patricia M Behlmer | Psychiatry & Neurology | 3640 High St, Ste. 1f, Portsmouth, VA 23707-3213 | 2008-04-23 |
| 1427229749 | Maryview Hospital | Psychiatry & Neurology | 3640 High St, Suite 1a, Portsmouth, VA 23707-3213 | 2008-03-14 |
| 1699853218 | Orthopaedic Surgery Centers, PC II | Durable Medical Equipment & Medical Supplies | 3640 High St, Suite 2a, Portsmouth, VA 23707-3213 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508410382 | Ricky Lee Key Sr. | Counselor | Kaleidoscope Counseling and Case Management, 1712 Airline Blvd, Portsmouth, VA 23707 | 2019-07-30 |
| 1528627965 | Amy M Baker | Student in an Organized Health Care Education/Training Program | 3640 High Street, Suite 2f Portsmouth Family Medicine, Portsmouth, VA 23707 | 2019-06-10 |
| 1033774625 | Himani Bhasin | Student in an Organized Health Care Education/Training Program | 3640 High Street (suite 2f), Evms Family Medicine - Portsmouth Program, Portsmouth, VA 23707 | 2019-05-08 |
| 1851854442 | Emma Daymond | Student in an Organized Health Care Education/Training Program | 3640 High Street, Suite 2f, Portsmouth, VA 23707 | 2019-04-10 |
| 1407329543 | Heart Harmony Home Health and Services | Home Health | 505 Cumberland Street, Suite 2, Portsmouth, VA 23707 | 2019-01-10 |
| 1548780869 | A. Richards Counseling & Psychotherapy, LLC | Substance Abuse Rehabilitation Facility | 720 Rodman Ave., Portsmouth, VA 23707 | 2017-06-27 |
| 1316485196 | Melinda Macy | Occupational Therapy Assistant | 314 Florida Ave, Portsmouth, VA 23707 | 2017-02-01 |
| 1831526045 | Anointed and Blessed Home Health Care, LLC | Home Health | 806 Loudoun Ave, Portsmouth, VA 23707 | 2013-10-02 |
| 1639236284 | The Center for Pain Management | Clinic/Center | 3315 High Street, Portsmouth, VA 23707 | 2007-01-02 |
| 1750444741 | Wal-mart Stores East, Lp | Technician/Technologist | 1098 Fredrick Blvd, Portsmouth, VA 23707 | 2006-12-19 |
| Find all providers in zip 23707 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316112444 | Jessica B Wallaert | Surgery | 200 Griffin Rd Ste 12a, Portsmouth, NH 03801-7145 | 2008-04-29 |
| 1871759480 | Tolulope Kofi Akinyemi | Surgery | 200 Griffin Rd, Suite 6, Portsmouth, NH 03801-7145 | 2008-08-03 |
| 1255593828 | Syed Mohiuddin Peeran | Surgery | 200 Griffin Rd Ste 6, Portsmouth, NH 03801-7145 | 2008-06-25 |
| 1336346808 | Marion Richard Hochstetler Jr. | Surgery | 1711 27th St Ste 206, Portsmouth, OH 45662-2669 | 2007-06-28 |
| 1245203629 | William Robert Wilson Jr. | Surgery | 333 Borthwick Ave, Ste 402, Portsmouth, NH 03801-7128 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670930 | Usa Vein Clinics of Chantilly LLC | Surgery | 3914 Centreville Rd Ste 125, Chantilly, VA 20151-3289 | 2019-07-11 |
| 1285115998 | Sentara Medical Group | Surgery | 397 Little Neck Rd Ste 110, Virginia Beach, VA 23452-5774 | 2018-08-22 |
| 1629586417 | Sentara Medical Group | Surgery | 1051 Loftis Blvd Ste 210, Newport News, VA 23606-3069 | 2018-01-16 |
| 1942724620 | Sentara Medical Group | Surgery | 500 Sentara Cir Ste 100, Williamsburg, VA 23188-5727 | 2017-08-03 |
| 1972980761 | Carlos Jose Torres-medina | Surgery | 500 J Clyde Morris Blvd # 603, Newport News, VA 23601-1929 | 2015-04-30 |
| 1306280128 | Justin Marc Milligan | Surgery | 397 Little Neck Rd Ste 120, Virginia Beach, VA 23452-5774 | 2013-04-23 |
| 1578817938 | Clinch Valley Vascular Surgical Assoc., Pllc | Surgery | 6719 Gov. G.c. Peery Highway, Suite 2600, Richlands, VA 24641 | 2012-11-06 |
| 1346503463 | Mid Atlantic Vascular Holding, LLC | Surgery | 1415 Eastridge Rd, Richmond, VA 23229-5501 | 2012-06-22 |
| 1265791297 | Vascular Surgery Group | Surgery | 850 Chistensen Court, Great Falls, VA 22066 | 2012-05-11 |
| 1902122922 | Hao Duy Pham | Surgery | 6719 Governor Gc Peery Hwy Ste 2600, Richlands, VA 24641 | 2010-04-15 |
| Find all providers with the same taxonomy | ||||
| City | PORTSMOUTH |
| Zip Code | 23707 |
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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.