NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Pediatric Physicians

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1396950853
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Pediatric Physicians
Practice address
1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440
Phone
(757) 252-9600
Fax
(757) 275-9896
NPI assigned
May 10, 2007
Last updated
Sep 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Mrs. Cindy A Taylor
Title
Manager
Phone
(757) 252-3344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440

Mailing address

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454-2440
Phone (757) 252-9600

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Pediatric Physicians Doing business as

National Provider Directory

National Provider Directory

Locations

1800 Camelot Dr
Ste 200
Virginia Beach, VA 23454
Phone (757) 252-9600

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": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1396950853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR",
            "address_2": "STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-252-9600",
            "fax_number": "757-275-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CAMELOT DR",
            "address_2": "STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542440",
            "telephone_number": "757-252-9600",
            "fax_number": "757-275-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-3344",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "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 Pediatric Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.