Organization Active NPI

Primary Care of West End LLC

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1205998176
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE OF WEST END LLC
Practice address
2004 Bremo Rd
Ste. 201
Richmond, VA 23226-2442
Phone
(804) 239-1640
Fax
(804) 239-1655
NPI assigned
Dec 15, 2006
Last updated
Nov 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Suzanne Bergamo
Title
VP
Phone
(804) 267-5950

Specialties & licenses 1

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

Addresses

Primary practice location

2004 Bremo Rd
Ste. 201
Richmond, VA 23226-2442

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 373-7406

Other identifiers 1

IdentifierTypeStateIssuer
1205998176MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070418000203 VA Part B Supplier - Clinic/Group Practice 4385749456 Receives reassigned benefits from 2 practitioners
Practice locations: Richmond, VA; Henrico, VA

National Provider Directory

National Provider Directory

Locations

12018 W Broad St
Richmond, VA 23233
Phone (804) 217-9091

12018 W Broad St
Ste 101
Richmond, VA 23233
Phone (804) 217-9091

12050 W Broad St
Richmond, VA 23233
Phone (804) 217-9091

12720 Tuckahoe Creek Pkwy
Richmond, VA 23238
Phone (804) 325-5876

2004 Bremo Rd
Ste 201
Richmond, VA 23226
Phone (804) 239-1640

7660 E Parham Rd
Ste 100
Richmond, VA 23294
Phone (804) 266-0787

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1205998176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 BREMO RD",
            "address_2": "STE. 201",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262442",
            "telephone_number": "804-239-1640",
            "fax_number": "804-239-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE OF WEST END LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "BERGAMO",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "804-267-5950"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205998176",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 20, 2025; 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.