NPIMap

Individual provider Active NPI

Gregory W Sandine, PA-C

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1023204740
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110002622 Issued in VA
Practice address
7101 Jahnke Rd
Richmond, VA 23225-4017
Phone
(804) 323-8911
NPI assigned
Sep 16, 2007
Last updated
Feb 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002622 VA Primary

Addresses

Primary practice location

7101 Jahnke Rd
Richmond, VA 23225-4017

Mailing address

5665 New Northside Dr
Suite 320
Atlanta, GA 30328-5831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080403000172 VA Practitioner - Physician Assistant 6204913098 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110002622VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Pipit Emergency Physicians LLC Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients
Virginia Emergency Physicians LLP Physician Assistant Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1023204740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 JAHNKE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254017",
            "telephone_number": "804-323-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDINE",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.