Philip C Boulanger (NPI# 1083685366, PAC ID# 6507881901) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1083685366 |
| PAC ID by PECOS | 6507881901 |
| Professional Enrollment ID | I20051013000716 |
| Full Name | Philip C Boulanger |
| Organization Legal Name | LEGACY CARE LLC |
| Address |
2901 S Lynnhaven Rd Suite 450 Virginia Beach VA 23452-8524 |
| Phone Number | 7572220300 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1996 |
| Primary Specialty | GENERAL PRACTICE |
| Group Practice PAC ID | 0042458200 |
| Number of Group Practice Members | 102 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490032 | MEDICAL COLLEGE OF VIRGINIA HOSPITALS |
| 490007 | SENTARA NORFOLK GENERAL HOSPITAL |
| 490059 | BON SECOURS ST MARYS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 | 7572220300 | LEGACY CARE LLC |
| Organization Legal Name | LEGACY CARE LLC |
| Physicians | 105 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Helen L Cruz | Nurse Practitioner | Legacy Care LLC | 1840 Reisterstown Rd, Pikesville, MD 21208-1305 |
| Leroy Jackson | Endocrinology | Legacy Care LLC | 2900 Sabre St, Suite 300, Virginia Beach, VA 23452-7380 |
| Harsukh Panchabhai Patolia | Internal Medicine | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Tonja L Gadsden | Internal Medicine | Legacy Care LLC | 1015 15th St Nw, Suite 1000, Washington, DC 20005-2621 |
| Sidney Nelson Iii | Internal Medicine | Legacy Care LLC | 1840 Reisterstown Rd, Pikesville, MD 21208-1305 |
| Ralph D Hellams Jr. | Family Medicine | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Tracy T Germaine | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Judith L Albert | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Elizabeth Peters | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Emily Danielle Wilson | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Street Address |
2901 S LYNNHAVEN RD SUITE 450 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip | 23452-8524 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Harsukh Panchabhai Patolia | Internal Medicine | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Ralph D Hellams Jr. | Family Medicine | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Tracy T Germaine | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Judith L Albert | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Elizabeth Peters | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Emily Danielle Wilson | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Kristle Maria Chambers | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Kathleen Marie Anderson | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Krystal Kc Lauer | Nurse Practitioner | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| William C Reed Jr. | Internal Medicine | Legacy Care LLC | 2901 S Lynnhaven Rd, Suite 450, Virginia Beach, VA 23452-8524 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David E Ranzette | Chiropractic | 4664 S Blvd, Suite 101, Virginia Beach, VA 23452-1058 | |
| Aaron Mangino | Chiropractic | Health With Hands LLC | 441 S Independence Blvd, Suite 4, Virginia Beach, VA 23452-1105 |
| Scott J Birckbichler | Chiropractic | 485 S Independence Blvd, Suite 111, Virginia Beach, VA 23452-1129 | |
| Andra S Foster | Chiropractic | 505 S Independence Blvd, Suite 105, Virginia Beach, VA 23452-1150 | |
| James F Lassiter | Psychologist, Clinical | 4560 S Blvd, Suite 300, Virginia Beach, VA 23452-1160 | |
| James Maggio Jr. | Chiropractic | 525 S Independence Blvd, Suite 190, Virginia Beach, VA 23452-1189 | |
| Michael Amare | Chiropractic | 525 S Independence Blvd, Suite 190, Va Beach, VA 23452-1189 | |
| Molly Jordan Howlett | Qualified Audiologist | 4356 Bonney Rd, Bldg 1 Suite 102, Virginia Beach, VA 23452-1200 | |
| Robert Paul Seim | Optometry | 4217 Virginia Beach Blvd, Virginia Beach, VA 23452-1232 | |
| Brian Dolmat | Chiropractic | 4301 Virginia Beach Blvd, Virginia Beach, VA 23452-1250 | |
| Find all physicians in zip 23452 | |||
| City | VIRGINIA BEACH |
| Zip Code | 23452 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | VIRGINIA BEACH + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Philip C Boulanger.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.