NPIMap

Organization Active NPI

Weight Loss Surgery Center

  • Specialist
  • Newport News, VA
National Provider Identifier
1245394394
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101050712 Issued in VA
Legal business name
WEIGHT LOSS SURGERY CENTER
Practice address
645 J Clyde Morris Blvd
Newport News, VA 23601-1819
Phone
(757) 591-9572
Fax
(757) 591-9606
NPI assigned
Dec 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Shawn Joyner
Title
Office Manager
Phone
(757) 591-9572

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 0101050712 VA Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 0101236493 VA

Addresses

Primary practice location

645 J Clyde Morris Blvd
Newport News, VA 23601-1819

Mailing address

645 J Clyde Morris Blvd
Newport News, VA 23601-1819
Phone (757) 591-9572

Other identifiers 3

IdentifierTypeStateIssuer
138438OtherVAANTHEM DR. TERRACINA
453810OtherVAANTHEM DR. THOMAS CLARK
7312059MedicaidVA

National Provider Directory

National Provider Directory

Locations

645 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 591-9572

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245394394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011819",
            "telephone_number": "757-591-9572",
            "fax_number": "757-591-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011819",
            "telephone_number": "757-591-9572",
            "fax_number": "757-591-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIGHT LOSS SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOYNER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-591-9572",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101050712",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101236493",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM DR. TERRACINA",
            "identifier": "138438",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM DR. THOMAS CLARK",
            "identifier": "453810",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7312059",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.