Individual provider Active NPI

Jonathan Todd Fleenor, MD

  • Pediatric Cardiology Physician
  • Norfolk, VA
National Provider Identifier
1447210802
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
0101050240 Issued in VA
Practice address
601 Children'S Lane
Norfolk, VA 23507
Phone
(757) 668-7214
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 0101050240 VA Primary

Addresses

Primary practice location

601 Children'S Lane
Norfolk, VA 23507

Mailing address

601 Children'S Lane
Norfolk, VA 23507
Phone (757) 668-7214

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
I20081201000573 VA Practitioner - Cardiovascular Disease (Cardiology) 0345301958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Uniformed Services Uhs Fe Hebert School of Med, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

601 Childre'S LN
Norfolk, VA 23507-1910
Phone (757) 668-7007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC CurrentSince Jul 10, 2008 Accepting new patients

Locations

11783 Rock Landing Dr
Newport News, VA 23606
Phone (757) 668-6550

825 Fairfax Ave
Norfolk, VA 23507
Phone (757) 446-5955

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

2021 Concert Dr
Virginia Beach, VA 23456
Phone (757) 668-6550

6425 Richmond Rd
Williamsburg, VA 23188
Phone (757) 345-3242

Organizations & group practices 1

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1447210802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHILDREN'S LANE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23507",
            "telephone_number": "757-668-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDREN'S LANE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23507",
            "telephone_number": "757-668-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEENOR",
        "first_name": "JONATHAN",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101050240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.