Organization Active NPI

Appomattox River Primary Care, LLC

  • Internal Medicine Physician
  • Hopewell, VA
National Provider Identifier
1023764982
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
APPOMATTOX RIVER PRIMARY CARE, LLC
Practice address
815 W Poythress St
Hopewell, VA 23860-2532
Phone
(804) 458-8557
Fax
(804) 541-7113
NPI assigned
Mar 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Suzanne Bergamo
Title
Division VP/Ao
Phone
(804) 267-5950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

815 W Poythress St
Hopewell, VA 23860-2532

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 373-7406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220921000503 VA Part B Supplier - Clinic/Group Practice 8022493469 Receives reassigned benefits from 6 practitioners
Practice locations: Hopewell, VA; Colonial Heights, VA

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
49D2263145Appomattox River Primary Care LLC815 W Poythress St, Hopewell, VA 23860Certificate of waiverJun 22, 2028

National Provider Directory

National Provider Directory

Locations

3512 Boulevard
Colonial Hgts, VA 23834
Phone (804) 520-1110

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1023764982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W POYTHRESS ST",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602532",
            "telephone_number": "804-458-8557",
            "fax_number": "804-541-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPOMATTOX RIVER PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "BERGAMO",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "DIVISION VP/AO",
        "authorized_official_telephone_number": "804-267-5950"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.