Individual provider Active NPI

Alexandra Sledd Mack, M.D.

  • Family Medicine Physician
  • Norfolk, VA
National Provider Identifier
1174812192
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101260428 Issued in VA
Practice address
825 Fairfax Ave
Ste 118
Norfolk, VA 23507-1914
Phone
(757) 446-5955
Fax
(757) 446-5196
NPI assigned
Mar 30, 2011
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101260428 VA Primary

Addresses

Primary practice location

825 Fairfax Ave
Ste 118
Norfolk, VA 23507-1914

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 446-5955

Other practice location 1

2300 E Parham Rd
Richmond, VA 23228-3118
Phone (804) 264-7808

Other identifiers 15

IdentifierTypeStateIssuer
1174812192OtherVACIGNA
1174812192OtherVAVIRGINIA PREMIER HEALTH PLAN
1174812192OtherVAUSA MANAGED CARE
1174812192OtherVAAETNA
1174812192OtherVAMULTIPLAN
1174812192MedicaidNC
1174812192OtherVACOVENTRY HEALTH CARE
1174812192OtherVAUNITED HEALTHCARE
1174812192OtherVATRICARE/CHAMPUS
1174812192OtherVAHUMANA
1174812192OtherVAOPTIMA HEALTH
1174812192MedicaidVA
1174812192OtherVAANTHEM BC/BS
1174812192OtherVAVIRGINIA HEALTH NETWORK
1174812192OtherVACORVEL

Other names 1

  • Alexandra Sledd Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160822002480 VA Practitioner - Family Practice 0547488157 Reassigns benefits to 1 organization
I20240217000250 DC Practitioner - Family Practice 0547488157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tulane University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2300 E Parham Rd
Henrico, VA 23228-3118
Phone (804) 264-7808

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101260428VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Jan 7, 2024 Accepting new patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Jan 7, 2024 Accepting new patients
Coastal Podiatry, Inc PastSince Sep 1, 2016 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

2300 E Parham Rd
Richmond, VA 23228
Phone (804) 264-7808

Interoperability endpoints

  • Direct secure messaging: vaexchange@patientfirstclinics.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1174812192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "address_2": "STE 118",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5955",
            "fax_number": "757-446-5196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 E Parham Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232283118",
            "country_code": "US",
            "telephone_number": "804-264-7808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "ALEXANDRA",
        "middle_name": "SLEDD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101260428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER HEALTH PLAN",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA MANAGED CARE",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174812192",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTH CARE",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "1174812192",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "1174812192",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2300 E Parham Rd",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232283118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "SLEDD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.