NPIMap

Organization Active NPI

Bon Secours Memorial Regional Medical Center, Inc.

Doing business as Urbanna Medical Center

  • Family Medicine Physician
  • Urbanna, VA
National Provider Identifier
1386086643
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER, INC.
Doing business as
Urbanna Medical Center
Practice address
390 Virginia St
Suite a
Urbanna, VA 23175-9903
Phone
(804) 285-6020
Fax
(804) 758-2765
NPI assigned
Jul 26, 2013
Last updated
Jul 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Authorized official

Name
George Butler
Title
Director Corporate Responsibilty
Phone
(804) 281-0271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

390 Virginia St
Suite a
Urbanna, VA 23175-9903

Mailing address

390 Virginia St
Suite a
Urbanna, VA 23175-9903
Phone (804) 285-6020

Other names 1

  • Urbanna Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000687 VA Part B Supplier - Clinic/Group Practice 6507775293 Receives reassigned benefits from 75 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kilmarnock, VA; Glen Allen, VA; Richmond, VA; Mechanicsville, VA; King William, VA

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory

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": "1374796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374796800000",
    "number": "1386086643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 VIRGINIA ST",
            "address_2": "SUITE A",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "231759903",
            "telephone_number": "804-285-6020",
            "fax_number": "804-758-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 VIRGINIA ST",
            "address_2": "SUITE A",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "231759903",
            "telephone_number": "804-285-6020",
            "fax_number": "804-758-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR CORPORATE RESPONSIBILTY",
        "authorized_official_telephone_number": "804-281-0271"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urbanna Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbanna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.