Maryview Hospital LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MARYVIEW HOSPITAL LLC

Practice address

12720 McManus Blvd Ste 313
Newport News, VA 23602-4414

Phone

(757) 947-3190

Fax

(757) 947-3195

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Kimberly M Ralston

Title

System Director

Phone

(419) 996-5119

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bon Secours Liver Institute of Hampton Roads Doing business as

Locations (25 of 27)

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip C Alexander, FNP

  • Family Nurse Practitioner
  • Hampton, VA
  • NPI 1578860607
  NPD
• Margaret Aston, FNP-BC

  • Family Nurse Practitioner
  • Windsor, VA
  • NPI 1770057069
  NPD
• Karla Marie Pray, NP

  • Adult Health Nurse Practitioner
  • Gloucester, VA
  • NPI 1801153531
  NPD
• Mitchell L Shiffman, MD

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1497847461

  Gastroenterology

  NPD
• Savon Amos

  • Physical Therapist
  • Suffolk, VA
  • NPI 1326995788
  NPD (past)
• Heather Dann Britt, MOTR/L

  • Physical Rehabilitation Occupational Therapist
  • Suffolk, VA
  • NPI 1407319742
  NPD (past)
• Rachel S. Hatton, FNP

  • Family Nurse Practitioner
  • Norfolk, VA
  • NPI 1962730473
  NPD (past)
• Krystal Geneva Johnson, M.ED., ATC

  • Athletic Trainer
  • Suffolk, VA
  • NPI 1790096717
  NPD (past)
• Ronald H Jones, MD

  • Family Medicine Physician
  • Virginia Beach, VA
  • NPI 1982669776
  NPD (past)
• Rebekah Langreck, DPT

  • Physical Therapist
  • Portsmouth, VA
  • NPI 1164167037
  NPD (past)
• Elizabeth D Lanoue, MD

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1467416123
  NPD (past)
• Thienphuc My Le, DPT

  • Physical Therapist
  • Portsmouth, VA
  • NPI 1255869814
  NPD (past)

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1013439835",
    "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",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 MCMANUS BLVD STE 313",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024414",
            "telephone_number": "757-947-3190",
            "fax_number": "757-947-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVIEW HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C05149",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Liver Institute of Hampton Roads",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours Liver Institute of Hampton Roads",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Immaculate Hospital LLC
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• Mary Immaculate Nursing Center LLC
• Maryview Hospital LLC
• Maryview Hospital LLC
• Alison Mascalo, PH.D.
• Michael Andrew Mashburn
• Ednora Bradley Mason, APRN

• All providers in Newport News, VA
• Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.