SENTARA MEDICAL GROUP (NPI# 1639357239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639357239 |
Entity Type | Organization |
Organization Name | SENTARA MEDICAL GROUP |
Other Organization Name | NEW TOWN DIAGNOSTIC CENTER |
Practice Address |
4374 New Town Ave Suite 104 Williamsburg VA 23188-2865 |
Practice Telephone | 7572591335 |
Practice Fax Number | 7572591395 |
Mailing Telephone | 7572591335 |
Mailing Fax Number | 7572591395 |
Enumeration Date | 2008-02-06 |
Last Update Date | 2011-11-29 |
Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
Authorized Official Telephone | 7572523344 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
49D1080933 | VA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | MEDICARE GROUP NUMBER | C02033 | 01 |
Other Name | Type Code |
---|---|
New Town Diagnostic Center | 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 |
4374 NEW TOWN AVE SUITE 104 |
City | WILLIAMSBURG |
State | VA |
Zip Code | 23188-2865 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780658260 | Jennifer J Altman | Pediatrics | 4374 New Town Ave, Ste 202, Williamsburg, VA 23188-2865 | 2006-02-14 |
1205350584 | Velocity Urgent Care, LLC | Clinic/Center | 4374 New Town Ave, Williamsburg, VA 23188-2865 | 2017-07-28 |
1255677712 | Catherine A White | Licensed Practical Nurse | 4374 New Town Ave, Ste 200, Williamsburg, VA 23188-2865 | 2013-01-02 |
1689973000 | Julie W Jenkins | Nurse Practitioner | 4374 New Town Ave, Suite 202, Williamsburg, VA 23188-2865 | 2011-03-24 |
1437392396 | Sentara Medical Group | Clinical Medical Laboratory | 4374 New Town Ave, Suite 104a, Williamsburg, VA 23188-2865 | 2009-04-08 |
1265628093 | Jennifer Ashley Wolff Dean | Family Medicine | 4374 New Town Ave, Suite 100, Williamsburg, VA 23188-2865 | 2007-09-14 |
1659564557 | Erin C Desrosiers | Physician Assistant | 4374 New Town Ave, Suite 200, Williamsburg, VA 23188-2865 | 2007-08-23 |
1588855514 | Peter Alan Sim | Emergency Medicine | 4374 New Town Ave, Suite 100, Williamsburg, VA 23188-2688 | 2007-08-06 |
1699894972 | Michael Jesse Levine | Internal Medicine | 4374 New Town Ave, Ste 100, Williamsburg, VA 23188-2865 | 2007-03-28 |
1720106149 | Sentara Medical Group | Pediatrics | 4374 New Town Ave, Ste 202, Williamsburg, VA 23188-2865 | 2007-03-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
Find all providers in zip 23188 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932409703 | Riverside Radiology Medical Group, Inc. | Radiology | 104 Ormskirk, Williamsburg, VA 23188-8941 | 2010-10-27 |
1134373095 | Richard B. Circeo | Radiology | 35 Whittakers Mill Rd, Williamsburg, VA 23185-5534 | 2008-11-05 |
1356594352 | Jonathan Lavery Stolz | Radiology | 145 Captaine Graves, Williamsburg, VA 23185-8906 | 2008-11-04 |
1376554683 | Melinda Martin Dunn | Radiology | 400 Sentara Circle, Getty Outpatient Center Womens Imaging Center, Williamsburg, VA 23188 | 2006-08-11 |
1316958580 | Matthew C Allison | Radiology | 2824 Bennetts Pond Rd, Williamsburg, VA 23185 | 2006-08-11 |
1235119827 | Raymond E. Bozman | Radiology | 114 Edward Wyatt Dr, Williamsburg, VA 23188-6439 | 2006-01-19 |
1144204322 | Donald E La Vay | Radiology | 109 George Sandys, Williamsburg, VA 23185-8938 | 2005-12-01 |
1790029320 | Vpa PC | Radiology | 263 Mclaws Cir Ste 105, Williamsburg, VA 23185-5674 | 2012-11-20 |
1285945873 | Joshua Forrest Stephenson | Radiology | 100 Sentara Cir, Williamsburg, VA 23188 | 2010-06-29 |
1427251073 | Aleisha Johnson | Radiology | 5424 Discovery Park Blvd., Suite 109, Williamsburg, VA 23188-4430 | 2007-06-08 |
Find all providers in WILLIAMSBURG |
City | WILLIAMSBURG |
Zip Code | 23188 |
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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.