NPIMap

Organization Active NPI

Sentara Hospitals

Doing business as Sentara Obici Hospital Psychiatric Unit

  • Psychiatric Hospital Unit
  • Suffolk, VA
National Provider Identifier
1053475004
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
H 1869 Issued in VA
Legal business name
SENTARA HOSPITALS
Doing business as
Sentara Obici Hospital Psychiatric Unit
Practice address
2800 Godwin Blvd
Suffolk, VA 23434-8038
Phone
(757) 934-4751
NPI assigned
Dec 21, 2006
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SENTARA HEALTHCAREAs reported in NPPES

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
Psychiatric Hospital Unit 273R00000X H 1869 VA Primary

Addresses

Primary practice location

2800 Godwin Blvd
Suffolk, VA 23434-8038

Mailing address

1300 Sentara Park
Virginia Beach, VA 23464-5884

Other identifiers 1

IdentifierTypeStateIssuer
49-0044-8MedicaidVA

Other names 1

  • Sentara Obici Hospital Psychiatric Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://urldefense.proofpoint.com/v2/url?u=https-3A__cobiusconnect.cobius.com-3A8291_Gateway_Documen Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130731000574 VA Part A Provider - Hospital 3274424924 Practice locations: Suffolk, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053475004. Details of each certification follow.

Hospital certification: CCN 49S044

Legal name
SENTARA HOSPITALS
Doing business as
SENTARA OBICI HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jun 4, 1990 in VA
Enrollment address
2800 Godwin Boulevard
Suffolk, VA 23434-8034
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Sentara Healthcare2 organizations share this tax ID, including this one
Part of
Sentara Health Care

Other organizations with this tax ID 1

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

Interoperability endpoints

  • FHIR API: https://epicfhir.sentara.com/ARR-FHIR-PRD/api/FHIR/R4/

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dennis Matheis Individual Corporate Officer Sep 1, 2022
Corporate Director Sep 1, 2022
W-2 Managing Employee Sep 1, 2022
Dana P Miller Individual W-2 Managing Employee Jun 11, 2013
Eric Conley Individual Corporate Officer Apr 29, 2024
Corporate Director Apr 29, 2024
W-2 Managing Employee Apr 29, 2024
Michelle L Allen Individual W-2 Managing EmployeePatient Accounts Manager Oct 28, 2022
Robert a Broermann Individual Corporate Officer Jun 11, 2013
Corporate Director Jun 11, 2013
Cathy W Darden Individual W-2 Managing Employee May 3, 2019
Sentara Health Organization, Virginia Beach, VA Non-profit 5% Or Greater Direct Ownership Interest Jan 25, 2023 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sentara Albemarle Regional Medical CenterElizabeth City, NC, CCN 340109 Hospital Operational/Managerial Control (100%) Mar 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1053475004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SENTARA PARK",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 GODWIN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348038",
            "telephone_number": "757-934-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SENTARA HEALTHCARE",
        "enumeration_date": "2006-12-21",
        "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": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "VA",
            "license": "H 1869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49-0044-8",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://urldefense.proofpoint.com/v2/url?u=https-3A__cobiusconnect.cobius.com-3A8291_Gateway_Documen",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sentara Obici Hospital Psychiatric Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Obici Hospital Psychiatric Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.