BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER (NPI# 1922054287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922054287 |
| Entity Type | Organization |
| Organization Name | BON SECOURS DEPAUL MEDICAL CENTER IMAGE RECOVERY CENTER |
| Practice Address |
150 Kingsley Ln /suite #1 - Image Recovery Center Norfolk VA 23505-4602 |
| Practice Telephone | 7578895795 |
| Practice Fax Number | 7578895820 |
| Mailing Telephone | 7578895795 |
| Mailing Fax Number | 7578895820 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DANIEL DUGGAN (EVP/ADMINISTRATOR) |
| Authorized Official Telephone | 7578895851 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 1202014479 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 9109404 | 05 |
| Street Address |
150 KINGSLEY LN /SUITE #1 - IMAGE RECOVERY CENTER |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003812785 | Patrick B. Higdon | Family Medicine | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2005-06-27 |
| 1497385033 | Jennifer L Lemasters-stover | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2020-01-23 |
| 1356813083 | Sarah West Taylor | Clinical Nurse Specialist | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-12-19 |
| 1619443009 | Amarachi G Agbai | Registered Nurse | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-10-23 |
| 1043795867 | Lindsey Reprogle | Physician Assistant | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-09-27 |
| 1528549219 | Chika I Ogbolu | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-08-22 |
| 1457846024 | Gia Martin | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-06-26 |
| 1295237477 | Shannon Coulson | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2018-03-05 |
| 1053834960 | Kathryn Alise Gale | Nurse Practitioner | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2017-07-23 |
| 1881139434 | Corinna Brander | Nurse Practitioner | 150 Kingsley Ln, Neuroscience Office, Norfolk, VA 23505-4602 | 2017-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154844256 | Cassandra Shelton | Specialist/Technologist, Other | 100 Kingsley Lane, Norfolk, VA 23505 | 2017-07-20 |
| 1063942852 | Gabriela Marie Santiago | Specialist/Technologist | 7600 Victory Dr, Apt 3, Norfolk, VA 23505 | 2017-06-14 |
| 1144776725 | Amr Hassan | Pharmacist | 1610 W Little Creek Rd, Apt 204, Norfolk, VA 23505 | 2016-09-01 |
| 1992175095 | Heather Mitchell | Nurse Practitioner | 110 Kingsley Ln Ste 309, Norfolk, VA 23505 | 2015-10-01 |
| 1255710620 | Jessica Ann Kestranek | Dentist | 7400 Granby St Ste D, Norfolk, VA 23505 | 2015-05-19 |
| 1710375274 | Carla Toledo | Nurse Practitioner | 155 Kingsley Lane, Suite 400, Norfolk, VA 23505 | 2015-01-06 |
| 1417359746 | James Austin Valone Jr. | Ophthalmology | 1423 Runymede Rd, Norfolk, VA 23505 | 2014-09-18 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1649549361 | Linda Horsey | Social Worker | 7510 Granby Street, Suite 6, Norfolk, VA 23505 | 2011-12-27 |
| 1679705164 | Carolyn Lee Kee | Nurse's Aide | 7403 Hampton Blvd, Norfolk, VA 23505 | 2009-08-17 |
| Find all providers in zip 23505 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285164210 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 201 W 21st St Ste 6, Norfolk, VA 23517-2365 | 2017-06-13 |
| 1740718139 | Tactical Rehabilitation Inc | Durable Medical Equipment & Medical Supplies | 7724 Hampton Blvd, Norfolk, VA 23505-1738 | 2017-05-30 |
| 1740680719 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3717 Hampton Blvd, Norfolk, VA 23508-2425 | 2014-08-27 |
| 1285042127 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3350 E Princess Anne Rd, Norfolk, VA 23502-1564 | 2014-07-23 |
| 1912333097 | Nebraska Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1301 West Norfolk Ave, Norfolk, NE 68701 | 2013-09-19 |
| 1841536125 | Golden Touch Enterprise | Durable Medical Equipment & Medical Supplies | 5680 Lowey Rd, Unit 410b, Norfolk, VA 23502 | 2012-12-14 |
| 1679830467 | City Wide Enterprises | Durable Medical Equipment & Medical Supplies | 320 W 25th St, Norfolk, VA 23517-1310 | 2012-04-18 |
| 1356617971 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 471 N Military Hwy, Norfolk, VA 23502-5401 | 2012-03-28 |
| 1376814566 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6678 E Virginia Beach Blvd, Norfolk, VA 23502-3034 | 2012-01-19 |
| 1285914671 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3200 Lafayette Blvd, Norfolk, VA 23509-2548 | 2011-08-17 |
| 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.