NPIMap

Organization Active NPI

Bon Secours Memorial Regional Medical Center LLC

Doing business as Laburnum Medical Center

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1003849589
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Doing business as
Laburnum Medical Center
Practice address
4620 S Laburnum Ave
Richmond, VA 23231
Phone
(804) 226-2444
Fax
(804) 222-0458
NPI assigned
Jul 8, 2006
Last updated
Apr 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Cassie Lowe
Title
Director Payer Enrollment
Phone
(513) 952-5210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

4620 S Laburnum Ave
Richmond, VA 23231

Mailing address

PO Box 639995
Cincinnati, OH 45263-9995

Other practice location 1

8220 Meadowbridge Rd
Mechanicsville, VA 23116-2336
Phone (804) 764-2200

Other practice location 2

4630 S Laburnum Ave
Richmond, VA 23231-2424
Phone (804) 226-2444

Other identifiers 1

IdentifierTypeStateIssuer
CN5711OtherVARAILROAD MEDICARE

Other names 1

  • Laburnum Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

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
O20190507002423 VA Part B Supplier - Mass Immunization (Roster Biller Only) 6507775293 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Allen, VA; King William, VA; Mechanicsville, VA; Richmond, 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0227776Bon Secours Mercy Health Laburnum Medical Center4620 S Laburnum Ave, Richmond, VA 23231Certificate of waiverAug 10, 2027

National Provider Directory

National Provider Directory

Locations

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

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

8220 Meadowbridge Rd
Ste 203
Mechanicsvlle, VA 23116
Phone (804) 226-2444

8243 Meadowbridge Rd
Mechanicsvlle, VA 23116
Phone (804) 730-1481

1850 Pocahontas Trl
#202
Quinton, VA 23141
Phone (804) 285-8806

4630 S Laburnum Ave
Ste D
Richmond, VA 23231
Phone (804) 222-8400

7229 Forest Ave
Ste 112
Richmond, VA 23226
Phone (804) 281-0275

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1003849589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639995",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639995",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 S LABURNUM AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23231",
            "telephone_number": "804-226-2444",
            "fax_number": "804-222-0458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8220 Meadowbridge Rd",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231162336",
            "country_code": "US",
            "telephone_number": "804-764-2200",
            "fax_number": "804-764-3291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4630 S Laburnum Ave",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232312424",
            "country_code": "US",
            "telephone_number": "804-226-2444",
            "fax_number": "804-222-0458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "CASSIE",
        "authorized_official_title_or_position": "DIRECTOR PAYER ENROLLMENT",
        "authorized_official_telephone_number": "513-952-5210"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN5711",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laburnum Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Laburnum Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.