SENTARA MEDICAL GROUP (NPI# 1043606098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043606098 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | SENTARA FAMILY MEDICINE PHYSICIANS |
| Practice Address |
1915 Pocahontas Trl Ste F5 Williamsburg VA 23185-5663 |
| Practice Telephone | 7579849750 |
| Practice Fax Number | 7573453255 |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |
| Authorized Official Name | CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572522765 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | VA | Allopathic & Osteopathic Physicians | |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Other Name | Type Code |
|---|---|
| Sentara Family Medicine Physicians | 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 |
1915 POCAHONTAS TRL STE F5 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23185-5663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579412 | Marian Shearin | Technician | 112 Indian Circle, Williamsburg, VA 23185 | 2019-10-09 |
| 1093363251 | 1st Choice In-homecare, Inc. | Durable Medical Equipment & Medical Supplies | 161-a John Jefferson Road Ste 101, Williamsburg, VA 23185 | 2019-08-30 |
| 1265939482 | Michelle Antionette Hill | Counselor | 1769 Jamestown Rd Ste 107, Williamsburg, VA 23185 | 2018-04-13 |
| 1114437480 | Kimberly Anne Allan | Orthotic Fitter | 1811 Jamestown Rd., Williamsburg, VA 23185 | 2017-10-02 |
| 1881115590 | Shawn Patrick Mcnulty | Counselor | Colonial Behavioral Health, 1657 Merrimac Trail, Williamsburg, VA 23185 | 2017-07-03 |
| 1790215986 | Sea Change Therapy Pllc | Community/Behavioral Health | 3308 Ash Vw, Williamsburg, VA 23185 | 2017-06-19 |
| 1316479322 | Maureen Bounds | Pharmacist | 230 Gooch Dr, Williamsburg, VA 23185 | 2017-03-29 |
| 1386196970 | Joshua Desilva | Psychologist | 240 Gooch Drive, 2nd Floor, Williamsburg, VA 23185 | 2016-10-29 |
| 1750837001 | Ellen Lerose | Pharmacist | 5601-b Richmond Road, Williamsburg, VA 23185 | 2016-08-28 |
| 1194173922 | Michael C. Shuck, Dds PC | Dentist | 1480 Quarterpath Rd, Ste 2a, Williamsburg, VA 23185 | 2016-06-02 |
| Find all providers in zip 23185 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487138020 | Kenneth Allen Kleyn | Family Medicine | 5548 Millbrook Dr, Williamsburg, MI 49690-9214 | 2018-09-19 |
| 1487188579 | Christina A. Mutch | Family Medicine | 2225 S Henry St Ste U2, Williamsburg, VA 23185-3973 | 2017-04-14 |
| 1669835989 | Community Health Systems Inc. | Family Medicine | 8965 Shoestring Trail, Williamsburg, WV 24991-0010 | 2016-04-04 |
| 1386028769 | Crystal Lake Clinic P.C. | Family Medicine | 6170 Us Highway 31 N, Williamsburg, MI 49690-9306 | 2015-07-15 |
| 1548681216 | Marengo Memorial Hospital | Family Medicine | 498 N Highland St., Williamsburg, IA 52361-9695 | 2013-12-26 |
| 1265616221 | First Med of Williamsburg | Family Medicine | 312 Second Street, Williamsburg, VA 23185 | 2007-12-26 |
| 1740478601 | David May Do Pllc | Family Medicine | 3939 M-72 East #210, Williamsburg, MI 49690 | 2007-10-04 |
| 1588865026 | Deanna Lynne Trail | Family Medicine | 3096 Nathaniels Grn, Williamsburg, VA 23185-7505 | 2007-05-31 |
| 1801934682 | Giacomo A Ricciarelli | Family Medicine | 263 Mclaws Circle, Suite 105, Williamsburg, VA 23185-5629 | 2007-02-02 |
| 1366530586 | Thomas Doncaster | Family Medicine | 475 N Highway 25 W, Suite 100, Williamsburg, KY 40769-1576 | 2006-10-11 |
| Find all providers in WILLIAMSBURG | ||||
| City | WILLIAMSBURG |
| Zip Code | 23185 |
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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.