Active NPI
Northern Neck Surgical Services
- Specialist
- Kilmarnock, VA
National Provider Identifier
1275586240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101039744
- Legal business name
- NORTHERN NECK SURGICAL SERVICES
- Practice address
- 95 Harris Rd
Building 1
Kilmarnock, VA 22482-3845 - Phone
- (804) 435-1608
- Fax
- (804) 435-3872
- NPI assigned
- May 18, 2006
- 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
- Dr. Steven J Oltermann, M.D.
- Title
- President
- Phone
- (804) 435-1608
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0101039744 | VA | Primary |
Addresses
Primary practice location
95 Harris Rd
Building 1
Kilmarnock, VA 22482-3845
Mailing address
PO Box 1955
Kilmarnock, VA 22482-1955
Phone (804) 435-1608
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 079266 | Other | VA | ANTHEM |
| 60723 | Other | VA | SOUTHERN HEALTH |
| 7312768 | Medicaid | VA |
National Provider Directory
National Provider DirectoryLocations
95 Harris Rd
Bldg 1
Kilmarnock, VA 22482
Phone (804) 435-1608
Practitioners & affiliated clinicians
Practitioners 1
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": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1275586240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1955",
"city": "KILMARNOCK",
"state": "VA",
"postal_code": "224821955",
"telephone_number": "804-435-1608",
"fax_number": "804-435-3872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 HARRIS RD",
"address_2": "BUILDING 1",
"city": "KILMARNOCK",
"state": "VA",
"postal_code": "224823845",
"telephone_number": "804-435-1608",
"fax_number": "804-435-3872"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN NECK SURGICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "OLTERMANN",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "804-435-1608",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "VA",
"license": "0101039744",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "079266",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "60723",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7312768",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kilmarnock, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.