Active NPI
Wellspring Physician, P.C. - VA
- Family Medicine Physician
- Richmond, VA
National Provider Identifier
1255870192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WELLSPRING PHYSICIAN, P.C. - VA
- Practice address
- 100 Shockoe Slip FL 2
Richmond, VA 23219-4100 - Phone
- (877) 872-0370
- Fax
- (855) 908-2520
- NPI assigned
- Feb 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathryn J Sowerwine, MD
- Title
- Chief Medical Officer
- Phone
- (979) 221-1398
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | |||
| Emergency Medicine Physician | 207P00000X | |||
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | |||
| Psychiatry Physician | 2084P0800X |
Addresses
Primary practice location
100 Shockoe Slip FL 2
Richmond, VA 23219-4100
Mailing address
4359 Roans Chapel Rd
College Station, TX 77845-4096
Other practice location 1
309 N Washington Ave
Suite 13
Bryan, TX 77803-5368
Phone (979) 431-5664
Other names 1
- Wellspring Physician, P.C. (VA)
National Provider Directory
National Provider DirectoryLocations
100 Shockoe Slip
Richmond, VA 23219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785196800000",
"number": "1255870192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4359 ROANS CHAPEL RD",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778454096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SHOCKOE SLIP FL 2",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232194100",
"telephone_number": "877-872-0370",
"fax_number": "855-908-2520"
}
],
"practiceLocations": [
{
"address_1": "309 N Washington Ave",
"address_2": "Suite 13",
"address_purpose": "LOCATION",
"city": "Bryan",
"state": "TX",
"postal_code": "778035368",
"country_code": "US",
"telephone_number": "979-431-5664",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WELLSPRING PHYSICIAN, P.C. - VA",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-13",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A",
"authorized_official_last_name": "SOWERWINE",
"authorized_official_first_name": "KATHRYN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "979-221-1398",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Wellspring Physician, P.C. (VA)",
"code": "5",
"type": "Other Name"
}
]
}
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 Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.