SENTARA MEDICAL GROUP (NPI# 1710318241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710318241 |
| Entity Type | Organization |
| Organization Name | SENTARA MEDICAL GROUP |
| Practice Address |
2760 Godwin Blvd Ste 100 Suffolk VA 23434-8036 |
| Practice Telephone | 7579838650 |
| Practice Fax Number | 7579838673 |
| Mailing Telephone | 7579838650 |
| Mailing Fax Number | 7575389038 |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MRS. CINDY A TAYLOR (MANAGER) |
| Authorized Official Telephone | 7572522765 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE GROUP NUMBER | C02033 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2050 Hillpoint Blvd N, Suffolk, VA 234347181 | 7579838650 | 7575389038 |
| 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 |
2760 GODWIN BLVD STE 100 |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434-8036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245732353 | Ashley Tromblay | Physician Assistant | 2760 Godwin Blvd Ste 100, Suffolk, VA 23434-8036 | 2018-03-05 |
| 1699161679 | Erica Formato | Family Medicine | 2760 Godwin Blvd Ste 100, Suffolk, VA 23434 | 2015-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1912561713 | Revivication Counseling Services | Counselor | 814 Cripple Creek Lane, Suffolk, VA 23434 | 2019-04-26 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| Find all providers in zip 23434 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891287611 | Franklin Clinic Corp | Family Medicine | 3920 Bridge Rd Ste 305, Suffolk, VA 23435-1107 | 2018-06-06 |
| 1922418235 | Maryview Hospital | Family Medicine | 148 Burnetts Way, Ste 107, Suffolk, VA 23434-6149 | 2014-05-08 |
| 1164687190 | Margie Pantangco Pascual | Family Medicine | 5818-d Harbour View Blvd, Suite 250, Suffolk, VA 23435 | 2008-07-18 |
| 1083804728 | Franklin Clinic Corp | Family Medicine | 2790 Godwin Blvd Ste 320, Suffolk, VA 23434-8174 | 2007-07-30 |
| 1548463185 | Mckenney Medical Group, Pllc | Family Medicine | 6712a S Quay Rd, Suffolk, VA 23437-8697 | 2007-06-11 |
| 1144437039 | Center for Health and Diabetes, Pllc | Family Medicine | 131 N Saratoga St, Suffolk, VA 23434-5258 | 2007-05-17 |
| 1730263435 | Monique Mccarter Lee | Family Medicine | 157 N Main St, Suite A, Suffolk, VA 23434-4565 | 2006-10-25 |
| 1104849132 | Roger Guy Lever | Family Medicine | 2800 Godwin Blvd Fl 1, Suffolk, VA 23434-8038 | 2006-07-25 |
| 1962429498 | Obici Medical Management Services, Inc | Family Medicine | 1548 Holland Rd # B, Suffolk, VA 23434-6528 | 2006-07-17 |
| 1144251687 | Linda Kay Frey | Family Medicine | 2019 Meade Pkwy, Suffolk, VA 23434-4259 | 2006-07-05 |
| Find all providers in SUFFOLK | ||||
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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.