Active NPI
Mary Candace Whitehurst, MD
- Internal Medicine Physician
- Norfolk, VA
National Provider Identifier
1194734467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101041536
- Practice address
- 930 W 21St St
Suite 100
Norfolk, VA 23517-1516 - Phone
- (757) 622-8358
- Fax
- (757) 622-7171
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101041536 | VA | Primary |
Addresses
Primary practice location
930 W 21St St
Suite 100
Norfolk, VA 23517-1516
Mailing address
7007 Harbour View Blvd
Suite 108
Suffolk, VA 23435-3657
Phone (757) 215-2784
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5824826 | Medicaid | VA | |
| 13900 | Other | VA | OPTIMA HEALTH PLAN |
| 325493 | Other | VA | ANTHEM BLUE CROSS BLUE SH |
| 011268 | Other | VA | CIGNA HEALTH PLAN |
| 1100181707 | Other | VA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Eastern Virginia Medical School, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3537 Airline Blvd
Suite 1
Portsmouth, VA 23701-2650
Phone (757) 738-1225
930 W 21St St
Suite 100
Norfolk, VA 23517-1516
Phone (757) 622-8358
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101041536 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medicine Specialist Inc | Internal Medicine | Current | Accepting new patients |
| Bon Secours Medical Group Hampton Roads Primary Care LLC | Internal Medicine | Current | Accepting new patients |
Locations
155 Kingsley Ln
Ste 400
Norfolk, VA 23505
Phone (757) 278-2240
930 W 21st St
Ste 100
Norfolk, VA 23517
Phone (757) 622-8358
3537 Airline Blvd
Ste 1
Portsmouth, VA 23701
Phone (757) 738-1225
8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462
828 Healthy Way
Ste 220
Virginia Beach, VA 23462
Phone (757) 305-1797
Interoperability endpoints
- mwhitehurst1156858@direct.bsmhealth.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Richmond, VA
- NPI 1528627379
-
- Internal Medicine Physician
- Norfolk, VA
- NPI 1851458244
Hospital & facility affiliations 16
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1003265075
-
- General Acute Care Hospital
- Chesapeake, VA
- NPI 1700896354
-
- General Acute Care Hospital
- Suffolk, VA
- NPI 1104658434
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464134400000",
"number": "1194734467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7007 HARBOUR VIEW BLVD",
"address_2": "SUITE 108",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234353657",
"telephone_number": "757-215-2784",
"fax_number": "757-215-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 W 21ST ST",
"address_2": "SUITE 100",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235171516",
"telephone_number": "757-622-8358",
"fax_number": "757-622-7171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHURST",
"first_name": "MARY",
"middle_name": "CANDACE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2016-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101041536",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5824826",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH PLAN",
"identifier": "13900",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "325493",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLAN",
"identifier": "011268",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "1100181707",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}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 May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.