NPIMap

Organization Active NPI

Martha Jefferson Medical Group LLC

Doing business as Sentara Martha Jefferson Inpatient Services

  • Hospitalist Physician
  • Charlottesville, VA
National Provider Identifier
1306380381
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
MARTHA JEFFERSON MEDICAL GROUP LLC
Doing business as
Sentara Martha Jefferson Inpatient Services
Practice address
500 Martha Jefferson Dr
Mailbox #G236
Charlottesville, VA 22911-4668
Phone
(434) 654-7580
Fax
(434) 654-7582
NPI assigned
Dec 12, 2016
Last updated
Sep 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Dr. Bruce Clemons, MDNPI 1871536755
Title
Vice President, Medical Director
Phone
(434) 654-5229

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
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

500 Martha Jefferson Dr
Mailbox #G236
Charlottesville, VA 22911-4668

Mailing address

PO Box 746550
Atlanta, GA 30374-6550
Phone (434) 654-7340

Other names 1

  • Sentara Martha Jefferson Inpatient Services Doing business as

National Provider Directory

National Provider Directory

Locations

500 Martha Jefferson Dr
#G236
Charlottesvle, VA 22911
Phone (434) 654-7580

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1306380381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746550",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746550",
            "telephone_number": "434-654-7340",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "address_2": "MAILBOX #G236",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA JEFFERSON MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "CLEMONS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VICE PRESIDENT, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "434-654-5229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Martha Jefferson Inpatient Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Martha Jefferson Inpatient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.