NPIMap

Organization Active NPI

Bon Secours-Richmond Community Hospital LLC

Doing business as Bon Secours Liver Institute of Richmond

  • Gastroenterology Physician
  • Richmond, VA
National Provider Identifier
1255889648
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC
Doing business as
Bon Secours Liver Institute of Richmond
Practice address
5855 Bremo Rd Ste 509
Richmond, VA 23226-1925
Phone
(804) 977-8920
Fax
(804) 282-2918
NPI assigned
Sep 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
William Kusnierz
Title
Cfo
Phone
(864) 282-4993

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

5855 Bremo Rd Ste 509
Richmond, VA 23226-1925

Mailing address

PO Box 639992
Cincinnati, OH 45263-9992

Other identifiers 1

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN

Other names 1

  • Bon Secours Liver Institute of Richmond Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000466 VA Part B Supplier - Clinic/Group Practice 3274425459 Receives reassigned benefits from 62 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Richmond, VA; Midlothian, VA; Kilmarnock, VA; Charlottesville, VA; Mechanicsville, VA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours - Richmond Community Hospital Incorporated7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12720 McManus Blvd
Ste 313
Newport News, VA 23602
Phone (757) 947-3190

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1255889648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639992",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD STE 509",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261925",
            "telephone_number": "804-977-8920",
            "fax_number": "804-282-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-RICHMOND COMMUNITY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "KUSNIERZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-282-4993"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Liver Institute of Richmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 13, 2022; 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.