NPIMap

Organization Active NPI

Sentara Medical Group

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1265617864
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SENTARA MEDICAL GROUP
Practice address
1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019
Phone
(757) 507-0400
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Authorized official

Name
Mrs. Cindy A Taylor
Title
Manager
Phone
(757) 252-2765

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X

Addresses

Primary practice location

1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019

Mailing address

1950 Glenn Mitchell Dr
Suite 310
Virginia Beach, VA 23456-0019
Phone (757) 507-0400

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Specialty Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1265617864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR",
            "address_2": "SUITE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR",
            "address_2": "SUITE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-2765",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Specialty Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.