NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Podiatry Specialists

  • Podiatrist
  • Norfolk, VA
National Provider Identifier
1487056115
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Podiatry Specialists
Practice address
844 Kempsville Rd
Ste 104
Norfolk, VA 23502-3927
Phone
(757) 261-0041
Fax
(757) 431-7770
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Mrs. Doris A Prince
Title
Director
Phone
(757) 983-5475

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X VA Primary
Durable Medical Equipment & Medical Supplies 332B00000X VA

Addresses

Primary practice location

844 Kempsville Rd
Ste 104
Norfolk, VA 23502-3927

Mailing address

844 Kempsville Rd
Ste 104
Norfolk, VA 23502-3927
Phone (757) 261-0041

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Podiatry Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Int Medi188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

844 Kempsville Rd
Ste 104
Norfolk, VA 23502
Phone (757) 252-5600

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1487056115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 KEMPSVILLE RD",
            "address_2": "STE 104",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023927",
            "telephone_number": "757-261-0041",
            "fax_number": "757-431-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 KEMPSVILLE RD",
            "address_2": "STE 104",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023927",
            "telephone_number": "757-261-0041",
            "fax_number": "757-431-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-983-5475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Podiatry Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Podiatry Specialists",
            "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 May 24, 2021; 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.