Individual provider Active NPI

Susan Kim-Foley, MD

  • Family Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1417921784
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101054091 Issued in VA
Practice address
713 Volvo Pkwy
Ste 100
Chesapeake, VA 23320-1614
Phone
(757) 548-0076
Fax
(757) 548-1652
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101054091 VA Primary

Addresses

Primary practice location

713 Volvo Pkwy
Ste 100
Chesapeake, VA 23320-1614

Mailing address

3241 Western Branch Blvd
Chesapeake, VA 23321-5260
Phone (757) 686-3508

Other identifiers 9

IdentifierTypeStateIssuer
541595397OtherVAVIRGINIA HEALTH NETWORK
11073OtherVASENTARA/OPTIMA
541595397OtherVACIGNA
541595397OtherVAPRIVATE HEALTHCARE SYSTEM
541595397OtherVAMID ATLANTIC SOLUTIONS
142918OtherVAANTHEM
4493819OtherVAAETNA
005604486MedicaidVA
541595397OtherVATRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100301000926 VA Practitioner - Family Practice 1355486408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101054091VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jan 1, 2001 Accepting new patients
Bayview Physician Services, PC Family Medicine CurrentSince Jan 1, 2001 Accepting new patients
Bayview Medical Center, Inc Past Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

713 Volvo Pkwy
Ste 100
Chesapeake, VA 23320
Phone (757) 548-0076

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1417921784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 WESTERN BRANCH BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215260",
            "telephone_number": "757-686-3508",
            "fax_number": "757-686-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 VOLVO PKWY",
            "address_2": "STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233201614",
            "telephone_number": "757-548-0076",
            "fax_number": "757-548-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-FOLEY",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101054091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "541595397",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "11073",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "541595397",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "541595397",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MID ATLANTIC SOLUTIONS",
            "identifier": "541595397",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "142918",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4493819",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005604486",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "541595397",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.