Individual provider Active NPI

David Amos, M.D.

  • Internal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1245679364
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25242 Issued in MS
Practice address
825 Fairfax Ave Ste 429
Norfolk, VA 23507-1914
Phone
(757) 446-7356
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 390200000 VA
Internal Medicine Physician 207R00000X 25242 MS Primary

Addresses

Primary practice location

825 Fairfax Ave Ste 429
Norfolk, VA 23507-1914

Mailing address

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171011000570 MS Practitioner - Internal MedicinePractitioner - Family Practice 4385944982 Practice locations: Jackson, MS
I20180821002819 VA Practitioner - Family PracticePractitioner - Hospitalist 4385944982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25242MSMDInternal Medicine Physician
390200000VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Peter J Jensen MD PC Past Accepting new patients

Locations

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

155 Kingsley Ln
Ste 150
Norfolk, VA 23505
Phone (757) 278-2350

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

2800 Godwin Blvd
Fl 1
Suffolk, VA 23434
Phone (757) 934-4821

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1245679364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 CHADWICK DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043404",
            "telephone_number": "601-376-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 429",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOS",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "390200000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "25242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.