BON SECOURS DEPAUL MEDICAL CENTER (NPI# 1457505711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457505711 |
| Entity Type | Organization |
| Organization Name | BON SECOURS DEPAUL MEDICAL CENTER |
| Other Organization Name | BON SECOURS PROVIDENCE MEDICAL ASSOCIATES |
| Practice Address |
5301 Providence Rd Suite 90 Virginia Beach VA 23464-4128 |
| Practice Telephone | 7574956896 |
| Practice Fax Number | 7574742223 |
| Mailing Telephone | 7574956896 |
| Mailing Fax Number | 7574742223 |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2008-11-12 |
| Authorized Official Name | GREG A SIMIA (CFO) |
| Authorized Official Telephone | 7576735928 |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS DEPAUL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Bon Secours Providence Medical Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336520618 | Bon Secours Depaul Medical Center | Family Medicine | 309 Battlefield Blvd S, Chesapeake, VA 23322-5311 | 2015-06-12 |
| 1740618412 | Bon Secours Depaul Medical Center | Internal Medicine | 400 Gresham Dr, Suite 808, Norfolk, VA 23507-1901 | 2013-10-16 |
| 1548520315 | Bon Secours Depaul Medical Center | Otolaryngology | 100 Kingsley Ln, Suite 404, Norfolk, VA 23505-4604 | 2012-05-25 |
| 1619251337 | Bon Secours Depaul Medical Center | Family Medicine | 1020 Independence Blvd, Suite 305, Virginia Beach, VA 23455-5500 | 2011-09-29 |
| 1366725160 | Bon Secours Depaul Medical Center | Internal Medicine | 1020 Independence Blvd, Sutie 206, Virginia Beach, VA 23455-5500 | 2011-09-28 |
| 1669779252 | Bon Secours Depaul Medical Center | Pain Medicine | 4445 Corporation Ln, Suite 120, Virginia Beach, VA 23462-3262 | 2011-02-17 |
| 1881998771 | Bon Secours Depaul Medical Center | Internal Medicine | 142 W York St, Suite 508, Norfolk, VA 23510-2015 | 2011-01-06 |
| 1316119332 | Bon Secours Depaul Medical Center | Internal Medicine | 6161 Kempsville Cir, Suite 335, Norfolk, VA 23502-3932 | 2008-03-31 |
| 1326181413 | Bon Secours Depaul Medical Center | Plastic Surgery | 150 Kingsley Ln, Norfolk, VA 23505-4602 | 2007-02-15 |
| Street Address |
5301 PROVIDENCE RD SUITE 90 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23464-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982657433 | Ivyrehab Sept, LLC | Occupational Therapist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2006-05-18 |
| 1427603182 | Rachel Hunter | Social Worker | 5301 Providence Rd, Virginia Beach, VA 23464-4128 | 2019-08-08 |
| 1245745603 | Dona Michelle Stover | Social Worker | 5301 Providence Rd, Virginia Beach, VA 23464-4128 | 2017-12-07 |
| 1952855603 | Megan Newcomb | Occupational Therapist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-08-11 |
| 1669925772 | Susan Pitcher | Speech-Language Pathologist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-07-26 |
| 1922450386 | Kathryn Peery Fuerst | Speech-Language Pathologist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-07-11 |
| 1174973101 | Kasie Healey | Speech-Language Pathologist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-06-21 |
| 1033567011 | Danielle Meghan Davis | Physical Therapist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-05-31 |
| 1225486673 | William Memery | Physical Therapist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-05-26 |
| 1265889497 | Brittany Joe Mowfy | Speech-Language Pathologist | 5301 Providence Rd, Suite 80, Virginia Beach, VA 23464-4128 | 2016-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610581 | Ainsley's Angels of America | Durable Medical Equipment & Medical Supplies | 828 Cabrini Place, Virginia Beach, VA 23464 | 2019-03-29 |
| 1104313055 | Your Family Is Family Home Healthcare Services, LLC | Respite Care | 1311 Hafford Road, Virginia Beach, VA 23464 | 2018-04-17 |
| 1497274765 | Jamie Crisman | Occupational Therapist | 1400 Fordham Drive, Virginia Beach, VA 23464 | 2017-09-18 |
| 1861919334 | Joshua Hoxter | Chiropractor | 6070 Indian River Rd Ste 102, Virginia Beach, VA 23464 | 2017-08-25 |
| 1669909917 | Toni Faye Tayag | Specialist/Technologist | 909 Tidemark Court, Virginia Beach, VA 23464 | 2017-05-17 |
| 1922545540 | Divinefavor LLC | Non-emergency Medical Transport (VAN) | 1014 Level Green Blvd, Virginia Beach, VA 23464 | 2017-01-20 |
| 1326499807 | David Klucznik | Dentist | 5564 Indian River Road, Virginia Beach, VA 23464 | 2016-06-27 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1588071807 | Linda Mathis | Skilled Nursing Facility | 5520 Indian Road, Virginia Beach, VA 23464 | 2014-07-18 |
| 1083045561 | Manny-nelson Med LLC | Durable Medical Equipment & Medical Supplies | 1612 Centerville Turnpike, Suite 308, Virginia Beach, VA 23464 | 2013-12-09 |
| Find all providers in zip 23464 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629422423 | Paris Ethan Pacheco | Internal Medicine | 1168 First Colonial Rd Ste 200, Virginia Beach, VA 23454-2444 | 2016-04-18 |
| 1477991529 | Leonardo Martin Oliva | Internal Medicine | 1060 First Colonial Rd Fl 1, Virginia Beach, VA 23454-3002 | 2013-06-11 |
| 1982940482 | Hilltop Healthcare LLC | Internal Medicine | 2132 Retreat Ct, Virginia Beach, VA 23454-2256 | 2013-01-02 |
| 1992071096 | Ravinderpal K Gill | Internal Medicine | 2901 S Lynnhaven Rd Ste 450, Virginia Beach, VA 23452 | 2012-03-22 |
| 1881962645 | Bert Wellington Holmes IIi | Internal Medicine | 1253 Nimmo Pkwy, Suite 110, Virginia Beach, VA 23456-7782 | 2011-12-08 |
| 1831483445 | Stella Alice Goings | Internal Medicine | 3908 Lake Front Cir, Suite 201, Virginia Beach, VA 23452-2712 | 2011-06-01 |
| 1063722510 | David S Haden Md PC | Internal Medicine | 5505 Indian River Rd Ste 101, Virginia Beach, VA 23464-5252 | 2010-10-18 |
| 1710293212 | Tidewater Integrative Health PC | Internal Medicine | 802 North Newtown Rd, Virginia Beach, VA 23462-1116 | 2010-08-23 |
| 1821316688 | Brian Joseph Lipps | Internal Medicine | 3074 Brickhouse Ct, Virginia Beach, VA 23452-6859 | 2010-05-04 |
| 1851627129 | Amy Marie Goodrich-harris | Internal Medicine | 2008 Winding Lake Ct, Virginia Beach, VA 23456-6305 | 2009-10-21 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23464 |
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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.