Bon Secours Depaul Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BON SECOURS DEPAUL MEDICAL CENTER

Doing business as

Bon Secours Fastcare

Practice address

309 Battlefield Blvd S
Chesapeake, VA 23322-5311

Phone

(757) 215-2777

NPI assigned

Jun 12, 2015

Last updated

Jun 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen A Smith

Title

Credentialing Specialist

Phone

(757) 215-2784

Specialties & licenses 1

Addresses

Other names 1

• BON SECOURS FASTCARE Doing business as

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1336520618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 HARBOUR VIEW BLVD",
            "address_2": "SUITE 108",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353657",
            "telephone_number": "757-215-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225311",
            "telephone_number": "757-215-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS DEPAUL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-215-2784"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS FASTCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kawena Rose Bohn, PA-C
• Albert Dean Bohon Jr., O.D.
• Brittany Leah Bollenberg, MED, BCABA
• Krishna Bolling, LMSW
• Kendra L Bomgardner, MOT, ORT/L
• Bon Secours Depaul Medical Center Inc (Bon Secours Greenbrier Medical Associates)
• Tonya Bond, RESIDENT IN COUNSELI
• Taleisha Bondhill
• Ami D. Bonman, RN
• Danielle Rene Boomer, DPT

• Family Medicine Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.