NPIMap

Organization Active NPI

Bon Secours-Virginia Healthsource

Doing business as Commonwealth Internal Medicine Associates

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1407889082
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BON SECOURS-VIRGINIA HEALTHSOURCE
Doing business as
Commonwealth Internal Medicine Associates
Practice address
9220 Forest Hill Ave
Suite 1-a
Richmond, VA 23235
Phone
(804) 560-8838
Fax
(804) 560-3527
NPI assigned
Jul 8, 2006
Last updated
Jul 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Authorized official

Name
George O. Butler, MBA
Title
Director, Corporate Responsibility
Phone
(804) 281-0271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

9220 Forest Hill Ave
Suite 1-a
Richmond, VA 23235

Mailing address

9220 Forest Hill Ave
Suite 1-a
Richmond, VA 23235-6800
Phone (804) 560-8838

Other identifiers 1

IdentifierTypeStateIssuer
CG5286OtherVARAILROAD MEDICARE

Other names 1

  • Commonwealth Internal Medicine Associates Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1407889082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 FOREST HILL AVE",
            "address_2": "SUITE 1-A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232356800",
            "telephone_number": "804-560-8838",
            "fax_number": "804-560-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 FOREST HILL AVE",
            "address_2": "SUITE 1-A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23235",
            "telephone_number": "804-560-8838",
            "fax_number": "804-560-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DIRECTOR, CORPORATE RESPONSIBILITY",
        "authorized_official_telephone_number": "804-281-0271",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG5286",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Internal Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Commonwealth Internal Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.