NPIMap

Organization Active NPI

Bon Secours Depaul Medical Center Inc

  • Cardiovascular Disease Physician
  • Norfolk, VA
National Provider Identifier
1316182835
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BON SECOURS DEPAUL MEDICAL CENTER INC
Practice address
100 Kingsley LN Ste 400
Norfolk, VA 23505-4604
Phone
(757) 889-5335
Fax
(757) 889-5356
NPI assigned
Dec 12, 2008
Organization subpart
Yes
Parent organization
BON SECOURS DEPAUL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Stephan Quiriconi
Title
Cfo
Phone
(804) 281-8301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

100 Kingsley LN Ste 400
Norfolk, VA 23505-4604

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5462

Other names 1

  • Cardiovascular Specialists Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1097608Cardiovascular Specialists100 Kingsley Lane, Suite 100, Norfolk, VA 23505Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory
Part of
Bon Secours Depaul Med Ctr

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1316182835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGSLEY LN STE 400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054604",
            "telephone_number": "757-889-5335",
            "fax_number": "757-889-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "enumeration_date": "2008-12-12",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cardiovascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.