Organization Active NPI

Virginia Institute of Plastic Surgery PC

  • Plastic Surgery Physician
  • Richmond, VA
National Provider Identifier
1245499276
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
0101236442 Issued in VA
Legal business name
VIRGINIA INSTITUTE OF PLASTIC SURGERY PC
Practice address
7611 Forest Ave
Suite 210
Richmond, VA 23229-4920
Phone
(804) 290-0909
Fax
(804) 290-0333
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Authorized official

Name
Burton Sundin, MDNPI 1164467601
Title
Ceo
Phone
(804) 290-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 0101236442 VA Primary

Addresses

Primary practice location

7611 Forest Ave
Suite 210
Richmond, VA 23229-4920

Mailing address

7611 Forest Ave
Suite 210
Richmond, VA 23229-4920
Phone (804) 290-0909

Other identifiers 1

IdentifierTypeStateIssuer
1245499276MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080822000659 VA Part B Supplier - Clinic/Group Practice 3375618580 Receives reassigned benefits from 2 practitioners
Practice locations: Richmond, VA

National Provider Directory

National Provider Directory

Locations

7611 Forest Ave
Ste 210
Richmond, VA 23229
Phone (804) 290-0909

7650 E Parham Rd
Ste 225
Richmond, VA 23294
Phone (804) 855-2050

1500 Cornerside Blvd
Ste 400
Vienna, VA 22182

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": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1245499276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 FOREST AVE",
            "address_2": "SUITE 210",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232294920",
            "telephone_number": "804-290-0909",
            "fax_number": "804-290-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 FOREST AVE",
            "address_2": "SUITE 210",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232294920",
            "telephone_number": "804-290-0909",
            "fax_number": "804-290-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA INSTITUTE OF PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "SUNDIN",
        "authorized_official_first_name": "BURTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-290-0909",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101236442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245499276",
            "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 May 28, 2009; 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.