NPIMap

Organization Active NPI

Fort Norfolk Plaza Medical Associates, LLC

Doing business as Fort Norfolk Plaza Urgent Care

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1154642783
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Doing business as
Fort Norfolk Plaza Urgent Care
Practice address
301 Riverview Avenue
Suite 502
Norfolk, VA 23510-1064
Phone
(757) 333-0284
Fax
(757) 961-0992
NPI assigned
Jun 17, 2010
Last updated
Oct 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Peggy Newby
Title
Cfo
Phone
(757) 624-1785

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

301 Riverview Avenue
Suite 502
Norfolk, VA 23510-1064

Mailing address

301 Riverview Ave Ste 502
Norfolk, VA 23510-1065
Phone (757) 333-0284

Other practice location 1

701 S Main St Ste A
Norfolk, VA 23523-1245
Phone (757) 937-8929

Other names 1

  • Fort Norfolk Plaza Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101222000618 VA Part B Supplier - Clinic/Group Practice 1456476787 Receives reassigned benefits from 5 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norfolk, VA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1154642783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 502",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101065",
            "telephone_number": "757-333-0284",
            "fax_number": "757-961-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVENUE",
            "address_2": "SUITE 502",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101064",
            "telephone_number": "757-333-0284",
            "fax_number": "757-961-0992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 S Main St Ste A",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235231245",
            "country_code": "US",
            "telephone_number": "757-937-8929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "NEWBY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-624-1785"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Norfolk Plaza Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.