Bon Secours-Virginia Healthsource Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BON SECOURS-VIRGINIA HEALTHSOURCE INC

Practice address

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309

Phone

(804) 443-5378

Fax

(804) 443-9667

NPI assigned

Apr 17, 2007

Organization subpart

Yes

Parent organization

BON SECOURS-VIRGINIA HEALTHSOURCE INCAs reported in NPPES

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

Authorized official

Name

Stephan Quiriconi

Title

Cfo

Phone

(804) 281-8301

Specialties & licenses 1

Addresses

Other names 1

• Tappahannock Primary Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Beaverdam Family Phy

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1356567457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1362 TAPPAHANNOCK BLVD",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225609309",
            "telephone_number": "804-443-5378",
            "fax_number": "804-443-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS-VIRGINIA HEALTHSOURCE INC",
        "enumeration_date": "2007-04-17",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tappahannock Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tappahannock Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beth L Faber DDS Ms PC
• Meenakshi Bindal, M.D.
• Stephen Joseph Blanchard, CRNA
• Carla Bojorquez, LCSW
• Alan M Bolash, MD
• Robert E Briggs, M.D.
• Vanessa Burns, ATC
• C-Med Company
• John Timothy Carmack, MD, MPH
• Amanda Casebolt, RBT

• Internal Medicine Physician in Tappahannock, VA
• Providers in Tappahannock, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.