NPIMap

Organization Active NPI

Innsbrook Plastic Surgery LLC

Doing business as Innsbrook Plastic Surgery

  • Ambulatory Surgical Clinic/Center
  • Glen Allen, VA
National Provider Identifier
1336267491
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0101223586 Issued in VA
Legal business name
INNSBROOK PLASTIC SURGERY LLC
Doing business as
Innsbrook Plastic Surgery
Practice address
4050 Innslake Dr
Suite 310
Glen Allen, VA 23060-3327
Phone
(804) 346-8700
Fax
(804) 346-1230
NPI assigned
Mar 27, 2007
Organization subpart
Yes
Parent organization
INNSBROOK PLASTIC SURGERY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Louise Diane Ferland, MDNPI 1376560284
Title
Buisness Owner
Phone
(804) 346-8700

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
Ambulatory Surgical Clinic/Center 261QA1903X 0101223586 VA Primary

Addresses

Primary practice location

4050 Innslake Dr
Suite 310
Glen Allen, VA 23060-3327

Mailing address

4050 Innslake Drive
Suite 310
Glen Allen, VA 23060-3327
Phone (804) 346-8700

Other identifiers 1

IdentifierTypeStateIssuer
246429OtherVABCBS AMB SURGERY CENTER #

Other names 1

  • Innsbrook Plastic Surgery Doing business as

National Provider Directory

National Provider Directory
Part of
Innsbrook Plastic Surgery LLC

Locations

4050 Innslake Dr
Ste 310
Glen Allen, VA 23060
Phone (804) 346-8700

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1336267491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DRIVE",
            "address_2": "SUITE 310",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603327",
            "telephone_number": "804-346-8700",
            "fax_number": "804-346-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR",
            "address_2": "SUITE 310",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603327",
            "telephone_number": "804-346-8700",
            "fax_number": "804-346-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNSBROOK PLASTIC SURGERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNSBROOK PLASTIC SURGERY  LLC",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "FERLAND",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "BUISNESS OWNER",
        "authorized_official_telephone_number": "804-346-8700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "0101223586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AMB SURGERY CENTER #",
            "identifier": "246429",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innsbrook Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.