NPIMap

Organization Active NPI

Fort Norfolk Plaza Medical Associates, LLC

  • Family Medicine Physician
  • Norfolk, VA
National Provider Identifier
1316274145
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Practice address
301 Riverview Avenue
Suite 525
Norfolk, VA 23510-1064
Phone
(757) 227-6866
Fax
(757) 277-0298
NPI assigned
Nov 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Peggy Newby
Title
Cfo
Phone
(757) 624-1785

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

301 Riverview Avenue
Suite 525
Norfolk, VA 23510-1064

Mailing address

301 Riverview Avenue
Suite 504
Norfolk, VA 23510-1064
Phone (757) 227-6866

Other identifiers 1

IdentifierTypeStateIssuer
VAA103549OtherGROUP PTAN

Other names 1

  • Fort Norfolk Plaza Primary Care, PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101222000618 VA Part B Supplier - Clinic/Group Practice 1456476787 Receives reassigned benefits from 5 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norfolk, VA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

700 Park Ave
Norfolk, VA 23504
Phone (757) 278-3360

301 Riverview Ave
Ste 504
Norfolk, VA 23510
Phone (757) 227-6866

301 Riverview Ave
Ste 500
Norfolk, VA 23510
Phone (757) 233-8252

301 Riverview Ave
Ste 50
Norfolk, VA 23510

301 Riverview Ave
Ste 515
Norfolk, VA 23510
Phone (757) 622-0453

301 Riverview Ave
Ste 525
Norfolk, VA 23510
Phone (757) 227-6866

Practitioners & affiliated clinicians

Practitioners 6

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": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1316274145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVENUE",
            "address_2": "SUITE 504",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101064",
            "telephone_number": "757-227-6866",
            "fax_number": "757-743-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVENUE",
            "address_2": "SUITE 525",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101064",
            "telephone_number": "757-227-6866",
            "fax_number": "757-277-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "NEWBY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-624-1785"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "VAA103549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Norfolk Plaza Primary Care, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Norfolk Plaza Primary Care, PC",
            "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 Jun 30, 2020; 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.