NPIMap

Organization Active NPI

Fort Norfolk Plaza Medical Associates, LLC

  • Cardiovascular Disease Physician
  • Norfolk, VA
National Provider Identifier
1396056982
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC
Doing business as
Fort Norfolk Plaza Cardiology Associates, Inc.
Fort Norfolk Plaza Cardiology,Inc.
Fort Norfolk Plaza Medical Associates, LLC d/b/a Fort Norfolk Plaza Cardiology, Inc.
Practice address
301 Riverview Ave Ste 500
Norfolk, VA 23510-1066
Phone
(757) 624-1785
NPI assigned
Jun 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Keith H Newby, M.D.NPI 1609809623
Title
President
Phone
(757) 624-1785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0001X
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

301 Riverview Ave Ste 500
Norfolk, VA 23510-1066

Mailing address

301 Riverview Avenue
Sutie 500
Norfolk, VA 23510-1064
Phone (757) 624-1785

Other identifiers 1

IdentifierTypeStateIssuer
VAA103548OtherGROUP PTAN

Other names 3

  • Fort Norfolk Plaza Cardiology Associates, Inc. Doing business as
  • Fort Norfolk Plaza Cardiology,Inc. Doing business as
  • Fort Norfolk Plaza Medical Associates, LLC d/b/a Fort Norfolk Plaza Cardiology, Inc. 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

Member organizations 1

Organizations listed as members of this organization in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1396056982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVENUE",
            "address_2": "SUTIE 500",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101064",
            "telephone_number": "757-624-1785",
            "fax_number": "757-624-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RIVERVIEW AVE STE 500",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101066",
            "telephone_number": "757-624-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "NEWBY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-624-1785",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "VAA103548",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Norfolk Plaza Cardiology Associates, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Norfolk Plaza Cardiology Associates, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Norfolk Plaza Cardiology,Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Norfolk Plaza Medical Associates, LLC d/b/a Fort Norfolk Plaza Cardiology, Inc.",
            "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 Jun 1, 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.