NPIMap

Organization Active NPI

Bon Secours - Memorial Regional Medical Center, Inc.

Doing business as The Bon Secours Program for Diabetes Health - Memorial Regional Medica

  • Endocrinology, Diabetes & Metabolism Physician
  • Mechanicsville, VA
National Provider Identifier
1003451410
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
BON SECOURS - MEMORIAL REGIONAL MEDICAL CENTER, INC.
Doing business as
The Bon Secours Program for Diabetes Health - Memorial Regional Medica
Practice address
8220 Meadowbridge Rd Ste 203
Mechanicsville, VA 23116-2339
Phone
(804) 764-7885
Fax
(804) 559-6185
NPI assigned
Nov 8, 2019
Last updated
Feb 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wilbur Gay
Title
Cfo
Phone
(864) 605-3762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

8220 Meadowbridge Rd Ste 203
Mechanicsville, VA 23116-2339

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149

Other names 1

  • THE BON SECOURS PROGRAM FOR DIABETES HEALTH - MEMORIAL REGIONAL MEDICA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000687 VA Part B Supplier - Clinic/Group Practice 6507775293 Receives reassigned benefits from 75 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kilmarnock, VA; Glen Allen, VA; Richmond, VA; Mechanicsville, VA; King William, VA

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Locations (25 of 26)

635 N Washington Hwy
Ashland, VA 23005
Phone (804) 798-9208

430 Clairmont Ct
Colonial Heights, VA 23834
Phone (804) 524-0610

10150 Staples Mill Rd
Ste E
Glen Allen, VA 23060
Phone (804) 755-7581

95 Harris Rd
Kilmarnock, VA 22482
Phone (804) 435-0023

95 Harris Rd
#1
Kilmarnock, VA 22482
Phone (804) 435-7735

6372 Mechanicsville Tpke
Ste 103
Mechanicsville, VA 23111
Phone (804) 379-0116

8200 Meadowbridge Rd
#306
Mechanicsville, VA 23116
Phone (804) 764-1253

8200 Meadowbridge Rd
Ste 102
Mechanicsville, VA 23116
Phone (804) 442-3670

8200 Meadowbridge Rd
Ste 203
Mechanicsville, VA 23116

8220 Meadowbridge Rd
Ste 107
Mechanicsville, VA 23116
Phone (804) 764-7191

8220 Meadowbridge Rd
Ste 110
Mechanicsville, VA 23116
Phone (804) 226-2444

8220 Meadowbridge Rd
Ste 113
Mechanicsville, VA 23116
Phone (804) 325-8882

8220 Meadowbridge Rd
Ste 313
Mechanicsville, VA 23116
Phone (804) 325-8882

8262 Atlee Rd
Ste 330
Mechanicsville, VA 23116
Phone (804) 325-8720

8220 Meadowbridge Rd
Ste 108
Mechanicsvlle, VA 23116
Phone (804) 559-6800

8220 Meadowbridge Rd
Ste 308
Mechanicsvlle, VA 23116
Phone (804) 325-8882

13700 St Francis Blvd
Ste 502
Midlothian, VA 23114
Phone (804) 423-8462

605 N Courthouse Rd
Ste 103
North Chesterfield, VA 23236
Phone (804) 378-1621

1300 Westwood Ave
Richmond, VA 23227
Phone (804) 254-6000

1400 Westwood Ave
#101
Richmond, VA 23227
Phone (804) 353-3618

1400 Westwood Ave
#106
Richmond, VA 23227
Phone (804) 359-0259

1510 N 28th St
Ste 204
Richmond, VA 23223
Phone (804) 225-7177

1510 N 28th St
Ste 210
Richmond, VA 23223
Phone (804) 730-1481

4620 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444

4630 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444

Practitioners & affiliated clinicians

Practitioners 101

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 101

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1003451410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 MEADOWBRIDGE RD STE 203",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162339",
            "telephone_number": "804-764-7885",
            "fax_number": "804-559-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS - MEMORIAL REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-605-3762"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE BON SECOURS PROGRAM FOR DIABETES HEALTH - MEMORIAL REGIONAL MEDICA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE BON SECOURS PROGRAM FOR DIABETES HEALTH - MEMORIAL REGIONAL MEDICA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.