NPIMap

Organization Active NPI

Optima Health Plan

Doing business as Sentara Community Care Center

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1053170167
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTIMA HEALTH PLAN
Doing business as
Sentara Community Care Center
Practice address
5116 Richmond Henrico Tpke
Richmond, VA 23227-3627
Phone
(804) 613-5907
Fax
(833) 491-4984
NPI assigned
Mar 19, 2024
Last updated
Mar 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Doris Prince
Title
Director
Phone
(757) 983-5475

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X NU

Addresses

Primary practice location

5116 Richmond Henrico Tpke
Richmond, VA 23227-3627

Mailing address

5116 Richmond Henrico Tpke
Richmond, VA 23227-3627
Phone (804) 613-5907

Other names 1

  • SENTARA COMMUNITY CARE CENTER Doing business as

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
49D2299505Sentara Community Care Center-Henrico5116 Richmond Henrico Turnpike, Richmond, VA 23227Provider-performed microscopyDec 9, 2026

National Provider Directory

National Provider Directory
Tax ID family
Optima Health Plan6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1053170167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 RICHMOND HENRICO TPKE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273627",
            "telephone_number": "804-613-5907",
            "fax_number": "833-491-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 RICHMOND HENRICO TPKE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273627",
            "telephone_number": "804-613-5907",
            "fax_number": "833-491-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HEALTH PLAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-983-5475"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SENTARA COMMUNITY CARE 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 Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.