NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Pratt Medical Group

  • Family Medicine Physician
  • Fredericksburg, VA
National Provider Identifier
1508240326
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Pratt Medical Group
Practice address
12101 Carol LN
Fredericksburg, VA 22407-6101
Phone
(540) 785-7810
Fax
(540) 786-3099
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Cindy A Taylor
Title
Manager
Phone
(757) 252-2765

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X VA
Family Medicine Physician 207Q00000X VA Primary
Pediatrics Physician 208000000X VA
Psychiatry Physician 2084P0800X VA
Physical Therapist 225100000X VA

Addresses

Primary practice location

12101 Carol LN
Fredericksburg, VA 22407-6101

Mailing address

12101 Carol LN
Fredericksburg, VA 22407-6101
Phone (540) 785-7810

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Pratt Medical Group 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

12101 Carol Ln
Fredericksburg, VA 22407
Phone (540) 368-7835

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1508240326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 CAROL LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076101",
            "telephone_number": "540-785-7810",
            "fax_number": "540-786-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 CAROL LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076101",
            "telephone_number": "540-785-7810",
            "fax_number": "540-786-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-2765"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "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 Pratt Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.