Bon Secours Medical Group Hampton Roads Specialty Care LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC

Doing business as

Southampton Orthopaedic and Sports Medicine Center

Practice address

6 Doctors Dr
Emporia, VA 23847-1240

Phone

(757) 562-7301

Fax

(757) 562-7305

NPI assigned

Jun 12, 2020

Last updated

Dec 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wilbur Gay

Title

Cfo

Phone

(864) 255-1904

Specialties & licenses 2

Addresses

Other names 1

• SOUTHAMPTON ORTHOPAEDIC AND SPORTS MEDICINE CENTER Doing business as

Locations

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1114542453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "866-496-9229",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DOCTORS DR",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471240",
            "telephone_number": "757-562-7301",
            "fax_number": "757-562-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-255-1904"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHAMPTON ORTHOPAEDIC AND SPORTS MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUTHAMPTON ORTHOPAEDIC AND SPORTS MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louann Avery
• Rhonda Banks
• Jonathan Bennett
• Kathryn Marie Bennett, D.C.
• Adel G Bishai, MD
• Bon Secours Mercy Health Emporia LLC (Bon Secours Southern Virginia Medical Center)
• Bon Secours Mercy Health Emporia LLC (Bon Secours - Southern Virginia Regional Medical Center)
• Bon Secours Mercy Health Emporia LLC (Bon Secours - Southern Virginia Reginal Medical Center)
• Audrey O Brown
• Gloria Denisha Brown, LPC

• Durable Medical Equipment & Medical Supplies in Emporia, VA
• Providers in Emporia, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.