DR. LAURA ANNE BOOMER (NPI# 1629192836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629192836 |
| Entity Type | Individual |
| Full Name | DR. LAURA ANNE BOOMER |
| Credential | MD |
| Practice Address |
1250 E Marshall St Richmond VA 23298-5051 |
| Mailing Address |
Po Box 91734 Richmond VA 23291-1734 |
| Practice Telephone | 8048283500 |
| Practice Fax Number | 8048288606 |
| Mailing Telephone | (804) 358-6100 |
| Mailing Fax Number | 8043427619 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2017-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
0101252572 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICAL LICENSE | 0101262572 | 01 |
| DEA | FB4552825 | 01 |
| Street Address |
1250 E MARSHALL ST |
| City | RICHMOND |
| State | VA |
| Zip Code | 23298-5051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265436158 | Elizabeth A Huntoon | Physical Medicine & Rehabilitation | 1250 E Marshall St, Physical Medicine and Rehab, Richmond, VA 23298-5051 | 2005-06-08 |
| 1700485943 | Jayme Holmes Kunkel | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-10-20 |
| 1508463068 | Benjamin Brickman Holt | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-10-07 |
| 1780298620 | Tara Lynne Taylor | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-09-08 |
| 1770197956 | Imane Chedid | Emergency Medicine | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-09-03 |
| 1659982338 | Randi Thompson | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-08-14 |
| 1619585684 | Chelsea Elise Snead | Nurse Practitioner | 1250 E Marshall St, Richmond, VA 23298-5023 | 2020-07-16 |
| 1285258095 | Trevor Harrison Nordin | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-06-08 |
| 1912521972 | Ashton Jordan Engdahl | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-06-04 |
| 1538783048 | Ann Forrest | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2020-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730703604 | Russell Wayne Dowell | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Em Residency/fellowship, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-06-05 |
| 1215551262 | Anna Leigh Cline | Student in an Organized Health Care Education/Training Program | Vcuhs Department of Emergency Medicine, 980401, 1250 E Marshall Street, Richmond, VA 23298 | 2020-06-05 |
| 1598389629 | Annabel Eujung Baek | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Plastic Surgery Residency, 980154, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-06-04 |
| 1235752957 | Valerie Tammy Tran | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, 980509, 1250 E Marshall St, Richmond, VA 23298 | 2020-05-28 |
| 1386267193 | Michael Terribile | Student in an Organized Health Care Education/Training Program | Vcuhs Department of Pediatrics Residency, 980163, Richmond, VA 23298 | 2020-05-27 |
| 1417585449 | Ryan Louis Naum | Student in an Organized Health Care Education/Training Program | Vcuhs Dept. of Neurology Residency, #980599, 1250 E. Marshall Street, Richmond, VA 23298 | 2020-03-27 |
| 1477102531 | Shanon Fitzpatrick Beam | Nurse Practitioner | Vcu Medical Center, 1250 East Marshall Street, Richmond, VA 23298 | 2019-09-10 |
| 1922666924 | Sumerth Kumar Pathak | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Psychiatry, 980710, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
| 1467010595 | Christopher Bednarz | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Surgery Residency, 980118, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
| 1629636782 | Nicholet Mitchell | Student in an Organized Health Care Education/Training Program | Vcuhs Dept of Em Residency/fellowship, 980401, 1250 E. Marshall Street, Richmond, VA 23298 | 2019-06-04 |
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| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215926332 | Richmond Pediatric Surgeons LLC | Surgery | 7115 Jahnke Rd, Richmond, VA 23225-4017 | 2005-10-20 |
| 1295829125 | Patricia A Lange | Surgery | 1250 E Marshall Street, Richmond, VA 23298-0510 | 2006-10-03 |
| 1427049113 | Claudio Oiticica | Surgery | 7101 Jahnke Rd, Richmond, VA 23225-4017 | 2005-11-02 |
| 1265423735 | Charles E Bagwell | Surgery | 7101 Jahnke Rd, Richmond, VA 23225-4017 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063196 | Madeleine Holden Snidow | Surgery | 3760 Reeds Landing Cir, Midlothian, VA 23113-1369 | 2020-11-02 |
| 1649884719 | Amal Y Elkhatib | Surgery | 2914 Myrtlewood Dr, Dumfries, VA 22026-2202 | 2020-09-04 |
| 1306074323 | Iljana Marjorie Gaffar | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2009-06-29 |
| 1811275407 | Bharath Dwaraka Nath | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2011-07-29 |
| 1811160971 | Daniel E. Levin | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2008-04-10 |
| 1700088242 | Fairfax Neonatal Associates, PC | Surgery | 2730 Prosperity Ave, Ste C, Fairfax, VA 22031-4329 | 2007-06-05 |
| 1700095916 | Joseph Edmond Hartwich | Surgery | 2730 Prosperity Ave Ste B, Fairfax Neonatal Associates, Fairfax, VA 22031-4324 | 2007-05-22 |
| 1063546869 | Bradley M. Rodgers | Surgery | Uva Hospital W, Hospital Drive, Charlottesville, VA 22908-0001 | 2007-03-15 |
| 1992839716 | Eugene D. Mcgahren IIi | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2007-03-15 |
| 1942390836 | Stephen S Kim | Surgery | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2006-10-13 |
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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.