CHESAPEAKE HOSPITAL LLC (NPI# 1932699303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932699303 |
| Entity Type | Organization |
| Organization Name | CHESAPEAKE HOSPITAL LLC |
| Other Organization Name | BON SECOURS LIVELY MEDICAL CENTER |
| Practice Address |
36 Lively Oaks Rd Lively VA 22507 |
| Mailing Address |
Po Box 639991 Cincinnati OH 45263-9991 |
| Practice Telephone | 8044625155 |
| Practice Fax Number | 8044625922 |
| Mailing Telephone | 8046275573 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | KIMBERLY RALSTON (SYSTEM DIRECTOR) |
| Authorized Official Telephone | 4199965119 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bon Secours Lively Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548750904 | Chesapeake Hospital LLC | Family Medicine | 9891 General Puller Hwy, Hartfield, VA 23071-3122 | 2018-05-11 |
| 1073003455 | Chesapeake Hospital LLC | Clinic/Center | 402 N Main St, Kilmarnock, VA 22482 | 2018-05-11 |
| 1013407543 | Chesapeake Hospital LLC | Clinic/Center | 9891 General Puller Hwy, Hartfield, VA 23071-3122 | 2018-05-10 |
| 1275023707 | Chesapeake Hospital LLC | Clinic/Center | 8152 Northumberland Hwy, Heathsville, VA 22473-3309 | 2018-05-10 |
| 1609226539 | Chesapeake Hospital LLC | Medicare Defined Swing Bed Unit | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1699125526 | Chesapeake Hospital LLC | General Acute Care Hospital | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| 1790135622 | Chesapeake Hospital LLC | Psychiatric Unit | 101 Harris Rd, Kilmarnock, VA 22482-3880 | 2016-06-22 |
| Street Address |
36 LIVELY OAKS RD |
| City | LIVELY |
| State | VA |
| Zip Code | 22507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407835937 | Salvatore Karl Bavuso | Family Medicine | 36 Lively Oaks Rd, Lively, VA 22507 | 2006-01-12 |
| 1043700347 | Chesapeake Hospital Corporation | Family Medicine | 36 Lively Oaks Rd, Lively, VA 22507 | 2018-05-14 |
| 1811165764 | Christine Collins | Family Medicine | 36 Lively Oaks Rd, Lively, VA 22482-4054 | 2008-02-13 |
| 1306945266 | Lively Drug Company Inc | Pharmacy | 36 Lively Oaks Rd, State Rt 3, Lively, VA 22507 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851594238 | Susan Huss Brooke | Counselor | 826 Monaskon Rd, Lively, VA 22507 | 2007-06-06 |
| 1265452171 | Ellen A Kingsbury | Anesthesiology | 36 Lively Oaks Road, Lively, VA 22507 | 2006-07-20 |
| 1831192939 | John Wesley Melton IIi | Internal Medicine | 36 Lively Oaks Rd., Lively, VA 22507 | 2005-05-23 |
| 1306386974 | Erin K Corsa | Nurse Practitioner | 36 Lively Oaks Road, Lively, VA 22507 | 2017-03-02 |
| 1720259187 | Chesapeake Medical Group, Inc. | Family Medicine | 36 Lively Oaks Road, Lively, VA 22507 | 2008-03-13 |
| 1073755104 | Golden Girl, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 999 B Street, Ceredo, WV 22507-0876 | 2009-04-06 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1366791972 | Free Clinic of Franklin County | Clinic/Center | 1171 Franklin Street, Rocky Mount, VA 24151 | 2012-08-29 |
| 1487818902 | St. Mary's Health Wagon | Clinic/Center | 233 Chase St., Clintwood, VA 24228 | 2008-07-14 |
| 1609054733 | Mountain States Health Alliance | Clinic/Center | 16431 Wise Street, Saint Paul, VA 24283-3537 | 2008-01-31 |
| 1013199322 | Page Memorial Hospital, Inc. | Clinic/Center | 505 Williams Ave, Shenandoah, VA 22849-1263 | 2007-11-28 |
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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.