NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Family & Internal Medicine Physicians

  • Family Medicine Physician
  • Lake Ridge, VA
National Provider Identifier
1346601309
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Family & Internal Medicine Physicians
Practice address
12825 Minnieville Rd
Ste 202
Lake Ridge, VA 22192-3601
Phone
(703) 780-2800
Fax
(844) 700-6186
NPI assigned
Mar 17, 2016
Last updated
Aug 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Authorized official

Name
Cindy A Taylo
Title
Manager
Phone
(757) 252-2765

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X VA Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X VA
Durable Medical Equipment & Medical Supplies 332B00000X VA

Addresses

Primary practice location

12825 Minnieville Rd
Ste 202
Lake Ridge, VA 22192-3601

Mailing address

12825 Minnieville Rd
Ste 202
Lake Ridge, VA 22192-3601
Phone (703) 780-2800

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Family & Internal Medicine Physicians Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Int Medi188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1346601309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD",
            "address_2": "STE 202",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923601",
            "telephone_number": "703-780-2800",
            "fax_number": "844-700-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12825 MINNIEVILLE RD",
            "address_2": "STE 202",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923601",
            "telephone_number": "703-780-2800",
            "fax_number": "844-700-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "TAYLO",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-2765"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Family & Internal Medicine Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Ridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.