Bon Secours St. Francis Medical Center, Inc.
Organization Active NPI Family Medicine Physician · Midlothian, VA
NPI 1104227263 · NPPES record last updated Sep 9, 2014
Key facts
- NPI
- 1104227263
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BON SECOURS ST. FRANCIS MEDICAL CENTER, INC.
- Practice address
- 200 Charter Colony Pkwy
Midlothian, VA 23114-4584 - Phone
- (804) 281-0275
- Fax
- (804) 521-9344
- NPI assigned
- Sep 9, 2014
- Organization subpart
- No
Authorized official
- Name
- George O Butler
- Title
- Director Corporate Responsibility
- Phone
- (804) 281-0271
Other NPIs on the same Medicare enrollment 21
Practitioners 2
-
Melissa N. Clayton, A.N.P.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050920000437 | VA | Part B Supplier - Clinic/Group Practice | 0648215418 |
Receives reassigned benefits from 61 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chester, VA; Midlothian, VA; Powhatan, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
200 Charter Colony Pkwy
Midlothian, VA 23114-4584
Mailing address
200 Charter Colony Pkwy
Midlothian, VA 23114-4584
Phone (804) 281-0275
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C09633 | Other | VA | GROUP PTAN |
Other names
- Bon Secours FastCare
Other providers in Midlothian, VA
- Bon Secours St. Francis Medical Center LLC
- Bon Secours St. Francis Medical Center LLC
- Bon Secours St. Francis Medical Center LLC
- Bon Secours St. Francis Medical Center LLC
- Bon Secours St. Francis Medical Center LLC
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours St. Francis Medical Center, Inc.
- Bon Secours Virginia Medical Group I, LLC
All providers in Midlothian, VA · Family Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.