Organization Active NPI

Retreat Surgical Associates LLC

  • Surgery Physician
  • Richmond, VA
National Provider Identifier
1285721035
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
RETREAT SURGICAL ASSOCIATES LLC
Practice address
101 Corwardin Ave
Suite 201
Richmond, VA 23224
Phone
(804) 230-4116
Fax
(804) 230-4355
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Authorized official

Name
Carol Smith
Title
VP
Phone
(804) 237-7760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

101 Corwardin Ave
Suite 201
Richmond, VA 23224

Mailing address

101 Corwardin Ave
Suite 201
Richmond, VA 23224
Phone (804) 230-4116

Other identifiers 1

IdentifierTypeStateIssuer
1285721035MedicaidVA

National Provider Directory

National Provider Directory

Locations

101 Cowardin Ave
Ste 201
Richmond, VA 23224
Phone (804) 230-4116

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1285721035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CORWARDIN AVE",
            "address_2": "SUITE 201",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-230-4116",
            "fax_number": "804-230-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CORWARDIN AVE",
            "address_2": "SUITE 201",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23224",
            "telephone_number": "804-230-4116",
            "fax_number": "804-230-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETREAT SURGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "804-237-7760"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285721035",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 12, 2007; 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.