NPIMap

Organization Active NPI

Bon Secours-Virginia Healthsource Inc

  • Surgery Physician
  • Richmond, VA
National Provider Identifier
1487922183
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BON SECOURS-VIRGINIA HEALTHSOURCE INC
Practice address
5855 Bremo Rd Ste 506
Richmond, VA 23226-1925
Phone
(804) 285-3225
Fax
(804) 285-0360
NPI assigned
Dec 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Authorized official

Name
Stephan Quiriconi
Title
Cfo
Phone
(804) 281-8301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

5855 Bremo Rd Ste 506
Richmond, VA 23226-1925

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5462

Other practice location 1

1510 N 28th St Ste 210
Richmond, VA 23223-5311
Phone (804) 893-8676

Other practice location 2

8266 Atlee Rd
Mechanicsville, VA 23116-1804
Phone (804) 746-7491

Other identifiers 1

IdentifierTypeStateIssuer
C06695OtherVAGROUP PTAN

Other names 1

  • BON SECOURS SURGICAL SPECIALIST AT ST MARY'S HOSPITAL Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1487922183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD STE 506",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261925",
            "telephone_number": "804-285-3225",
            "fax_number": "804-285-0360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 N 28th St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232235311",
            "country_code": "US",
            "telephone_number": "804-893-8676",
            "fax_number": "804-225-7365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8266 Atlee Rd",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231161804",
            "country_code": "US",
            "telephone_number": "804-746-7491",
            "fax_number": "804-764-7495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS SURGICAL SPECIALIST AT ST MARY'S HOSPITAL",
            "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 Jun 14, 2019; 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.