COMMONWEALTH PRIMARY CARE (NPI# 1487011367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487011367 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH PRIMARY CARE |
| Other Organization Name | COMMONWEALTH EXTENDED CARE |
| Practice Address |
1800 Glenside Dr Suite 103 Richmond VA 23226-3769 |
| Practice Telephone | 8042857425 |
| Practice Fax Number | 8046737074 |
| Mailing Telephone | 8042857425 |
| Mailing Fax Number | 8046737074 |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |
| Authorized Official Name | DR. KARISSA L. HACKELTON (MEDICAL DIRECTOR/PHYICIAN/SHAREHOLD) |
| Authorized Official Telephone | 8042857425 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024172915 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Commonwealth Extended Care | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831242353 | Commonwealth Primary Care | Physical Medicine & Rehabilitation | 4050 Innslake Dr Ste 308, Glen Allen, VA 23060 | 2007-01-19 |
| 1336157858 | Commonwealth Primary Care | Family Medicine | 4050 Innslake Dr, Ste 308, Glen Allen, VA 23060 | 2006-08-03 |
| 1689609182 | Commonwealth Primary Care | Family Medicine | 1529 Huguenot Rd, Suite A, Midlothian, VA 23113-2426 | 2006-07-12 |
| 1407881907 | Commonwealth Primary Care | Radiology | 1109 West Marshall Street, Richmond, VA 23220 | 2006-07-12 |
| 1982033411 | Commonwealth Primary Care | Clinic/Center | 1614 Peachtree Pkwy, Suite # 200, Cumming, GA 30041-6883 | 2013-11-05 |
| 1356532634 | Commonwealth Primary Care | Physical Medicine & Rehabilitation | 9930 Independence Park Dr, Suite 101, Richmond, VA 23233-1476 | 2007-08-05 |
| 1750571287 | Commonwealth Primary Care | Family Medicine | 1800 Glenside Dr Ste 105, Richmond, VA 23226-3769 | 2007-07-31 |
| 1487716676 | Commonwealth Primary Care | Family Medicine | 2200 Pump Rd, Suite 100, Richmond, VA 23233-3539 | 2006-12-14 |
| 1851464887 | Commonwealth Primary Care | Family Medicine | 5360 Twin Hickory Rd, Glen Allen, VA 23059-5682 | 2006-11-16 |
| 1780693804 | Commonwealth Primary Care | Family Medicine | 8903 Three Chopt Rd, Richmond, VA 23229 | 2006-08-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Commonwealth Primary Care Inc. | 1800 Glenside Dr, Ste 105, Richmond, Virginia 23226 |
| Street Address |
1800 GLENSIDE DR SUITE 103 |
| City | RICHMOND |
| State | VA |
| Zip Code | 23226-3769 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841564 | Edwin G Robinson | Family Medicine | 1800 Glenside Dr, Suite 105, Richmond, VA 23226-3769 | 2005-06-15 |
| 1215183348 | Debra S Colby | Audiologist | 1800 Glenside Dr, Suite 120, Richmond, VA 23226-3769 | 2008-08-08 |
| 1831398171 | Elizabeth Rhamy | Physician Assistant | 1800 Glenside Dr, Suite #110, Richmond, VA 23226-3769 | 2007-07-17 |
| 1306902705 | Erin S Poston | Physician Assistant | 1800 Glenside Dr, Ste 105, Richmond, VA 23226-3769 | 2006-12-29 |
| 1740341841 | Karissa L Hackelton | Family Medicine | 1800 Glenside Dr, Suite 110, Richmond, VA 23226-3769 | 2006-12-12 |
| 1023177052 | Angela D Middleton | Family Medicine | 1800 Glenside Dr, Suite 110, Richmond, VA 23226-3769 | 2006-12-06 |
| 1598774614 | Commonwealth Primary Care | Family Medicine | 1800 Glenside Dr, Suite 110, Richmond, VA 23226-3769 | 2006-08-07 |
| 1114960184 | Margaret Clair Westin | Family Medicine | 1800 Glenside Dr, Ste 110, Richmond, VA 23226-3769 | 2006-06-14 |
| 1962441881 | Richard L Gergoudis | Family Medicine | 1800 Glenside Dr, Ste 110, Richmond, VA 23226-3769 | 2006-06-06 |
| 1295774131 | William Richard Jeter | Family Medicine | 1800 Glenside Dr, Ste 110, Richmond, VA 23226-3769 | 2006-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033625744 | Eye Surgeons of Richmond, Inc. | Eyewear Supplier (Equipment, not the service) | 5875 Bremo Rd Ste 606, Richmond, VA 23226 | 2017-12-18 |
| 1922517028 | Karen Margaret Karwowski | Physical Therapist | 1901 Charles Street, Crestview Elementary School, Henrico, VA 23226 | 2017-09-21 |
| 1831636463 | Tammy A Lewis | Nurse Practitioner | 5803 Bremo Road, Richmond, VA 23226 | 2017-01-20 |
| 1497116438 | Ashton Williams | Counselor | 2008 Libbie Avenue, Suite 101, Richmond, VA 23226 | 2016-03-18 |
| 1396110078 | Nino Carlo Deleon | Dentist | 5500 Monument Ave Ste G, Richmond, VA 23226 | 2015-12-07 |
| 1083097794 | Amy Michelle Kruger | Podiatrist | 2008 Bremo Rd Ste 100, Richmond, VA 23226 | 2015-06-30 |
| 1841682762 | James Bryce Lothian | Pediatrics | 5875 Bremo Road, Mob South, Suite 303, Pediatric Lung Care, Richmond, VA 23226 | 2015-03-02 |
| 1811334980 | Carmen Wong | Physical Medicine & Rehabilitation | 1901 Libbie Ave, Richmond, VA 23226 | 2013-05-30 |
| 1841533890 | Lauren Etz Freeman | Nurse Practitioner | 7113 Three Chopt Road, Suite 101, Pediatric Associates of Richmond, Inc., Richmond, VA 23226 | 2013-03-28 |
| 1609126044 | Tammy Denise Mills | Nurse Practitioner | 1501 Maple Ave Ste 301, Richmond, VA 23226 | 2012-09-13 |
| Find all providers in zip 23226 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908519 | Demia Houston Louis | Nurse Practitioner | 19722 Norfolk Ridge Way, Richmond, TX 77407-7124 | 2020-10-07 |
| 1134726284 | Tara Hart | Nurse Practitioner | 521 Lancaster Ave # 223, Richmond, KY 40475-3102 | 2020-10-01 |
| 1689280372 | Chinyere Onyemaechi Adiuku | Nurse Practitioner | Chinyere Adiuku, 17831 Planters Path Lane, Richmond, TX 77407-7740 | 2020-09-18 |
| 1598379596 | Rebecca Pfeifer-rosenblum | Nurse Practitioner | 5939 Sutter Ave, Richmond, CA 94804-5260 | 2020-09-07 |
| 1578176970 | Grace Pulliam Gilmore | Nurse Practitioner | 29 Malvern Ave Apt 5, Richmond, VA 23221-2666 | 2020-08-25 |
| 1891306429 | Caroline Njuguna | Nurse Practitioner | 7210 Still Haven Dr, Richmond, TX 77407-7131 | 2020-08-17 |
| 1720699143 | Rukayat Omolara Yusuf | Nurse Practitioner | 8506 Heather Maple Ct, Richmond, TX 77407-2476 | 2020-08-10 |
| 1457969859 | Richmond Medical Group Inc | Nurse Practitioner | 1407 Mustang Lake Ct, Richmond, TX 77406-7961 | 2020-07-21 |
| 1093332744 | Patience I Nehikhuere | Nurse Practitioner | 7519 Misty Meadow Ct, Richmond, TX 77469-7322 | 2020-06-29 |
| 1275150252 | Ngozi Mba | Nurse Practitioner | 11335 Sandhaven Dr, Richmond, TX 77407-4534 | 2020-06-25 |
| Find all providers in RICHMOND | ||||
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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.