Organization Active NPI

Central Virginia Gynecologic Oncology PC

  • Gynecologic Oncology Physician
  • North Chesterfield, VA
National Provider Identifier
1285764738
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
0101036183 Issued in VA
Legal business name
CENTRAL VIRGINIA GYNECOLOGIC ONCOLOGY PC
Practice address
1401 Johnston Willis Dr
Suite
North Chesterfield, VA 23235-4730
Phone
(804) 323-5040
Fax
(804) 323-5070
NPI assigned
Mar 6, 2007
Last updated
Mar 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Randal J West, M.D.NPI 1861592339
Title
President
Phone
(804) 323-5040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 0101036183 VA Primary

Addresses

Primary practice location

1401 Johnston Willis Dr
Suite
North Chesterfield, VA 23235-4730

Mailing address

1401 Johnston Willis Dr
Suite 1100
North Chesterfield, VA 23235-4730
Phone (804) 323-5040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050621000692 VA Part B Supplier - Clinic/Group Practice 1052356078 Receives reassigned benefits from 4 practitioners
Practice locations: North Chesterfield, VA

National Provider Directory

National Provider Directory
Tax ID family
Central VA Gynecologic Oncology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

8266 Atlee Rd
Ste 322
Mechanicsvlle, VA 23116
Phone (804) 323-5040

1401 Johnston Willis Dr
#1100
North Chesterfield, VA 23235

1401 Johnston Willis Dr
Ste 1100
North Chesterfield, VA 23235
Phone (804) 323-5040

1423 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 323-5040

210 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 431-1100

9101 Stony Point Dr
Ste 3300
Richmond, VA 23235
Phone (804) 323-5040

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1285764738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR",
            "address_2": "SUITE 1100",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-323-5040",
            "fax_number": "804-323-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JOHNSTON WILLIS DR",
            "address_2": "SUITE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354730",
            "telephone_number": "804-323-5040",
            "fax_number": "804-323-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VIRGINIA GYNECOLOGIC ONCOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-323-5040",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "VA",
            "license": "0101036183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.