NPIMap

Organization Active NPI

Sentara Medical Group

  • Vascular Surgery Physician
  • Hampton, VA
National Provider Identifier
1356523641
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
SENTARA MEDICAL GROUP
Practice address
3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963
Phone
(757) 262-1110
Fax
(757) 510-9116
NPI assigned
Nov 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Authorized official

Name
Mrs. Doris Prince
Title
Manager
Phone
(757) 252-2760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963

Mailing address

3000 Coliseum Dr Ste 200
Hampton, VA 23666-5963
Phone (757) 262-1110

Other practice location 1

4000 Coliseum Dr
Ste 310
Hampton, VA 23666-5906
Phone (757) 262-1110

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Vascular Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Old Hampton Family Prac188 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

Locations

3000 Coliseum Dr
Ste 200
Hampton, VA 23666
Phone (757) 736-7250

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": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1356523641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665963",
            "telephone_number": "757-262-1110",
            "fax_number": "757-510-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665963",
            "telephone_number": "757-262-1110",
            "fax_number": "757-510-9116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Coliseum Dr",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665906",
            "country_code": "US",
            "telephone_number": "757-262-1110",
            "fax_number": "757-510-9116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-2760",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Vascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Vascular Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.