NPIMap

Organization Active NPI

Bon Secours-St. Mary's Hospital of Richmond, Inc.

Doing business as Bon Secours Pediatric Intensive Care Unit

  • Pediatric Critical Care Medicine Physician
  • Richmond, VA
National Provider Identifier
1184632671
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Doing business as
Bon Secours Pediatric Intensive Care Unit
Practice address
5801 Bremo Rd
Picu Unit
Richmond, VA 23226-1907
Phone
(804) 287-7017
Fax
(804) 287-7460
NPI assigned
Aug 3, 2006
Last updated
Oct 24, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
George O. Butler, MBA
Title
Director, Corporate Responsibility
Phone
(804) 281-0271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0203X Primary

Addresses

Primary practice location

5801 Bremo Rd
Picu Unit
Richmond, VA 23226-1907

Mailing address

5801 Bremo Rd
Picu Unit
Richmond, VA 23226-1907
Phone (804) 287-7017

Other names 1

  • Bon Secours Pediatric Intensive Care Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours St Marys Hospital21 organizations share this tax ID, including this one
Part of
Bon Secours St Marys Hospital

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1184632671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "address_2": "PICU UNIT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-287-7017",
            "fax_number": "804-287-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "address_2": "PICU UNIT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-287-7017",
            "fax_number": "804-287-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.",
        "enumeration_date": "2006-08-03",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DIRECTOR, CORPORATE RESPONSIBILITY",
        "authorized_official_telephone_number": "804-281-0271",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Pediatric Intensive Care Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours Pediatric Intensive Care Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.