NPIMap

Organization Active NPI

Fort Norfolk Plaza Medical Associates, LLC

  • Urgent Care Clinic/Center
  • Norfolk, VA
National Provider Identifier
1366092231
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Practice address
701 S Main St Ste a
Norfolk, VA 23523-1245
Phone
(757) 937-8929
NPI assigned
Sep 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Peggy Newby
Title
Cfo
Phone
(757) 624-1785

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

701 S Main St Ste a
Norfolk, VA 23523-1245

Mailing address

301 Riverview Ave Ste 500
Norfolk, VA 23510-1066
Phone (757) 624-1785

Other names 1

  • Fort Norfolk Plaza Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101222000618 VA Part B Supplier - Clinic/Group Practice 1456476787 Receives reassigned benefits from 5 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norfolk, VA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

301 Riverview Ave
Ste A
Norfolk, VA 23510

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1366092231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 500",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101066",
            "telephone_number": "757-624-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S MAIN ST STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235231245",
            "telephone_number": "757-937-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "NEWBY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-624-1785"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Norfolk Plaza Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.