NPIMap

Organization Active NPI

Halifax Regional Hospital, Inc

Doing business as Sentara Gynecology Specialists

  • Rural Health Clinic/Center
  • South Boston, VA
National Provider Identifier
1033728803
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HALIFAX REGIONAL HOSPITAL, INC
Doing business as
Sentara Gynecology Specialists
Practice address
2206 Wilborn Ave
Medical Office Building #1
South Boston, VA 24592
Phone
(434) 517-8627
NPI assigned
Jul 28, 2020
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Melinda Summerlin Hancock
Title
Cfo
Phone
(757) 455-7458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2206 Wilborn Ave
Medical Office Building #1
South Boston, VA 24592

Mailing address

2204 Wilborn Ave
South Boston, VA 24592-1645
Phone (757) 455-7395

Other practice location 1

101 Aubreys Loop
South Boston, VA 24592-5056
Phone (434) 517-8627

Other names 1

  • Sentara Gynecology Specialists Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040607000050 VA Part B Supplier - Clinic/Group Practice 4587572805 Receives reassigned benefits from 45 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nathalie, VA; South Boston, VA; Clarksville, VA; Chase City, VA
O20201112003144 VA Part A Provider - Other 4587572805 Practice locations: South Boston, VA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Halifax So Boston Comm8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2206 Wilborn Ave
Bldg 1
South Boston, VA 24592
Phone (434) 517-8627

2206 Wilborn Ave
Ofc
South Boston, VA 24592
Phone (434) 517-8627

2232 Wilborn Ave
Ste E
South Boston, VA 24592
Phone (434) 517-3169

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1033728803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921645",
            "telephone_number": "757-455-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 WILBORN AVE",
            "address_2": "MEDICAL OFFICE BUILDING #1",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "24592",
            "telephone_number": "434-517-8627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Aubreys Loop",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245925056",
            "country_code": "US",
            "telephone_number": "434-517-8627",
            "fax_number": "757-756-5126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HALIFAX REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUMMERLIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-455-7458"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Gynecology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.