SENTARA MEDICAL GROUP (NPI# 1114107729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114107729 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Other Organization Name | UROLOGY OF VIRGINIA |
| Practice Address |
1200 First Colonial Rd Ste 100g Virginia Beach VA 23454-2207 |
| Mailing Address |
Po Box 2502 Norfolk VA 23501-2502 |
| Practice Telephone | 7574813556 |
| Practice Fax Number | 7574963865 |
| Mailing Telephone | 7574813556 |
| Mailing Fax Number | 7574963865 |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2009-02-18 |
| Authorized Official Name | CINDY A TAYLOR (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 7576871076 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Urology of Virginia | 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 |
1200 FIRST COLONIAL RD STE 100G |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23454-2207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053345082 | Eye Surgery Limited LLC | Clinic/Center | 1200 First Colonial Rd, Suite 104, Virginia Beach, VA 23454-2207 | 2006-07-10 |
| 1316343478 | Riverside Hospital, Inc | General Acute Care Hospital | 1200 First Colonial Rd, Suite 204a, Virginia Beach, VA 23454-2207 | 2014-11-17 |
| 1144656133 | Angela Garcia | Nurse Practitioner | 1200 First Colonial Rd, Suite 202, Virginia Beach, VA 23454-2207 | 2013-09-23 |
| 1215242755 | Coastal Plastic Surgery Ltd | Surgery | 1200 First Colonial Rd, Suite 100, Virginia Beach, VA 23454-2274 | 2010-08-09 |
| 1972799567 | Justin D Martin | Dentist | 1200 First Colonial Rd, Suite #201, Virginia Beach, VA 23454-2207 | 2007-09-18 |
| 1396954715 | Dermatology Inc. of Virginia Beach | Clinic/Center | 1200 First Colonial Rd, Suite 200, Virginia Beach, VA 23454-2207 | 2007-05-22 |
| 1063583722 | Tidewater Anesthesia Inc | Nurse Anesthetist, Certified Registered | 1200 First Colonial Rd, Virginia Beach, VA 23454-2207 | 2006-11-13 |
| 1013924588 | George Charles Harr | Dermatology | 1200 First Colonial Rd, Suite 200, Virginia Beach, VA 23454-2207 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356994263 | Agape Consulting | Behavioral Analyst | 1216 Garth Court, Virginia Beach, VA 23454 | 2019-07-19 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1538639158 | Bay Psychiatric II Inc | Counselor | 923 First Colonial Rd Suite 1821, Virginia Beach, VA 23454 | 2018-11-26 |
| 1487151759 | Akanksha Mohan | Student in an Organized Health Care Education/Training Program | 100 Mannng Drive, Chapel Hill, Nc 27514, Chapel Hill, NC 23454 | 2018-04-12 |
| 1275038580 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1615 General Booth Blvd, Virginia Beach, VA 23454 | 2018-03-28 |
| 1346783164 | Tracy Chasse | Occupational Therapy Assistant | 1628 Old Donation Parkway, Virginia Beach, VA 23454 | 2016-11-28 |
| 1982066627 | Jennifer Mitchell | Speech-Language Pathologist | 2101 Agecroft Rd., Virginia Beach, VA 23454 | 2016-03-22 |
| 1659730562 | Rebecca Houvener | Psychologist | 1120 First Colonial Rd Ste 202, Virginia Beach, VA 23454 | 2016-02-19 |
| 1932581741 | Monica Jane Bailey | Nurse Practitioner | 2110 N Great Neck Rd, Virginia Beach, VA 23454 | 2015-06-29 |
| 1376930073 | Ashley A Burkholder | Family Medicine | 1024 First Colonial Rd Ste 104, Virginia Beach, VA 23454 | 2015-04-20 |
| Find all providers in zip 23454 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013146851 | William Vernon Tynes II | Urology | 2910 S Lynnhaven Road, Suite 170, Virginia Beach, VA 23452-8506 | 2009-07-14 |
| 1437266129 | Steven Scott Warden | Urology | 1004 1st Colonial Rd, Suite 101, Virginia Beach, VA 23454 | 2006-08-25 |
| 1174527113 | Bruce A Rosenfeld | Urology | 225 Clearfield Ave, Virginia Beach, VA 23462-1815 | 2005-06-08 |
| 1447513353 | Ilya J. Sobol | Urology | 225 Clearfield Ave, Virginia Beach, VA 23462 | 2012-06-18 |
| 1366732661 | Ramon Virasoro | Urology | 225 Clearfield Ave, Urology of Virginia, Virginia Beach, VA 23462-1815 | 2011-04-08 |
| 1295058394 | Michael Brandon Williams | Urology | 225 Clearfield Ave, Virginia Beach, VA 23462-1815 | 2010-03-04 |
| 1063747228 | Sentara Medical Group | Urology | 1925 Glenn Mitchell Dr, Suite 202, Virginia Beach, VA 23456-0170 | 2009-10-06 |
| 1205060902 | Joshua Langston | Urology | 225 Clearfield Ave, Virginia Beach, VA 23462-1815 | 2009-05-08 |
| 1538303185 | Sentara Medical Group | Urology | 800 Independence Blvd, Virginia Beach, VA 23455-6005 | 2009-04-27 |
| 1568605244 | Douglas Craig Kelly | Urology | 225 Clearfield Ave, Virginia Beach, VA 23462-1815 | 2009-04-11 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23454 |
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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.