BON SECOURS-VIRGINIA HEALTHSOURCE (NPI# 1972783918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972783918 |
| Entity Type | Organization |
| Organization Name | BON SECOURS-VIRGINIA HEALTHSOURCE |
| Other Organization Name | GLEN ALLEN INTERNAL MEDICINE |
| Practice Address |
5207 Hickory Park Dr Suite A Glen Allen VA 23059 |
| Mailing Address |
5207 Hickory Park Dr Suite A Glen Allen VA 23059-2624 |
| Practice Telephone | 8046212980 |
| Practice Fax Number | 8047627102 |
| Mailing Telephone | 8046212980 |
| Mailing Fax Number | 8047627102 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2018-07-27 |
| Authorized Official Name | GEORGE O. BUTLER (DIRECTOR, CORPORATE RESPONSIBILITY) |
| Authorized Official Telephone | 8042810271 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS-VIRGINIA HEALTHSOURCE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Glen Allen Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558379404 | Bon Secours-virginia Healthsource | Durable Medical Equipment & Medical Supplies | 8137 Staples Mill Rd, Richmond, VA 23228 | 2006-08-04 |
| 1528091808 | Bon Secours-virginia Healthsource | Family Medicine | 3311 Church Rd, Suite 100, Richmond, VA 23233 | 2006-07-09 |
| 1043243546 | Bon Secours-virginia Healthsource | Family Medicine | 4835 S Laburnum Ave, Richmond, VA 23231 | 2006-07-08 |
| 1235500281 | Bon Secours-virginia Healthsource | Internal Medicine | 7229 Forest Ave, Suite 112, Richmond, VA 23226 | 2015-10-16 |
| 1407129224 | Bon Secours-virginia Healthsource | Radiology | 7110 Forest Ave, Suite 100, Richmond, VA 23226 | 2012-02-10 |
| 1578708889 | Bon Secours-virginia Healthsource | Family Medicine | 3452 Anderson Hwy, Suite D, Powhatan, VA 23139 | 2008-12-16 |
| 1982857231 | Bon Secours-virginia Healthsource | Orthopaedic Surgery | 11601 Iron Bridge Rd, Suite 209, Chester, VA 23831 | 2008-10-30 |
| 1770730475 | Bon Secours-virginia Healthsource | Emergency Medicine | 7001 Forest Ave, Suite 103, Richmond, VA 23230 | 2008-08-25 |
| 1669638037 | Bon Secours-virginia Healthsource | Surgery | 5855 Bremo Rd, Suite 506, Richmond, VA 23226 | 2008-08-05 |
| 1073789285 | Bon Secours-virginia Healthsource | Internal Medicine | 5875 Bremo Rd, Suite G-11, Richmond, VA 23226 | 2008-05-07 |
| Street Address |
5207 HICKORY PARK DR SUITE A |
| City | GLEN ALLEN |
| State | VA |
| Zip Code | 23059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477543387 | Shelley B. Woodley | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2005-10-24 |
| 1568899409 | Bon Secours Virginia Medical Group I, LLC | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-10-10 |
| 1518301050 | Jason Anthony Leone | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2013-04-27 |
| 1063799302 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-11-15 |
| 1275829673 | Allison B Trevillian | Nurse Practitioner | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-06-23 |
| 1629377221 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-03-22 |
| 1811294614 | Shannon Jeanette Cannon | Registered Nurse | 5207 Hickory Park Dr, Suite C, Glen Allen, VA 23059-2624 | 2011-02-15 |
| 1407053713 | Aysha Habib | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2007-06-29 |
| 1720157357 | Julia K. Padgett | Dermatology | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2006-11-07 |
| 1699731554 | Jill Elaine Ryland | Pediatrics | 5207 Hickory Park Dr, Suite C, Glen Allen, VA 23059-2624 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422163 | Kusum Bhetwal | Nurse Practitioner | 12804 Westin Estates Drive, Glen Allen, VA 23059 | 2020-09-23 |
| 1538704770 | Rise Services LLC | Community/Behavioral Health | 11357 Nuckois Road, Suite 2043, Glen Allen, VA 23059 | 2019-11-12 |
| 1992347116 | Irene Anne Mcgovern | Technician | 5233 Eastbranch Dr, Glen Allen, VA 23059 | 2019-10-09 |
| 1427547322 | Sharon Ann Lott | Audiologist | Short Pump Middle School, 4701 Pouncey Tract Road, Glen Allen, VA 23059 | 2018-05-07 |
| 1518476423 | Thomas Joseph Stein | Pharmacist | 4912 Old Millrace Place, Glen Allen, VA 23059 | 2017-09-22 |
| 1033638440 | Caroline Taylor | Specialist/Technologist | 5143 Dorin Hill Ct., Glen Allen, VA 23059 | 2017-09-18 |
| 1003335167 | Rva Transport, Inc. | Non-emergency Medical Transport (VAN) | 830 Brassie Ln, Apt F, Glen Allen, VA 23059 | 2017-09-10 |
| 1639628407 | Jessica Jasmine Green | Nurse Practitioner | 4687 Poucey Tract Road, Glen Allen, VA 23059 | 2016-09-22 |
| 1255512760 | Peggy Ellen York | Psychologist | 13314 Greenwood Rd, Glen Allen, VA 23059 | 2007-11-27 |
| 1689795940 | Kim Blassic | Dentist | 5225 Hickory Park Dr., Suite D, Glen Allen, VA 23059 | 2007-04-03 |
| Find all providers in zip 23059 | ||||
| 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 |
|---|---|---|---|---|
| 1114564721 | Dada Bhagwan Inc | Internal Medicine | 5028 Hickory Meadows Pl, Glen Allen, VA 23059-2653 | 2019-12-02 |
| 1053715615 | Allyalign Health, Inc. | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2014-10-10 |
| 1679809727 | Bruce Margolis | Internal Medicine | 3828 Nightmuse Way, Glen Allen, VA 23059-4800 | 2009-10-26 |
| 1235368184 | Deepa Nandyal | Internal Medicine | 4508 Yorkminster Dr, Glen Allen, VA 23060-6157 | 2009-07-13 |
| 1558464073 | Deborah Josefson | Internal Medicine | 4355 Innslake Drive, Glen Allen, VA 23060 | 2006-09-07 |
| 1104854488 | Randall Morris | Internal Medicine | 10150 Staples Mill Rd, Suite E, Glen Allen, VA 23060-3452 | 2006-06-28 |
| 1992761423 | Springfield Medical Center, P.C. | Internal Medicine | 3970 Springfield Rd, Glen Allen, VA 23060-4119 | 2006-04-24 |
| 1477526507 | Charles W Brandt | Internal Medicine | 4900 Cox Rd, Suite 150, Glen Allen, VA 23060-6295 | 2006-02-09 |
| 1780073924 | Palmetto Long-term Care Coalition | Internal Medicine | 10900 Nuckols Rd, Suite 110, Glen Allen, VA 23060-9276 | 2015-01-12 |
| 1063799302 | Bon Secours-st. Mary's Hospital of Richmond, Inc. | Internal Medicine | 5207 Hickory Park Dr, Suite A, Glen Allen, VA 23059-2624 | 2011-11-15 |
| Find all providers in GLEN ALLEN | ||||
| City | GLEN ALLEN |
| Zip Code | 23059 |
Please comment or provide details below to improve the information on BON SECOURS-VIRGINIA HEALTHSOURCE.
| 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.