Mary Immaculate Hospital LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

MARY IMMACULATE HOSPITAL LLC

Practice address

2 Bernardine Dr
Newport News, VA 23602-4404

Phone

(757) 398-2208

Fax

(757) 398-2004

NPI assigned

Aug 14, 2015

Last updated

Sep 21, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

MARY IMMACULATE HOSPITAL LLCAs reported in NPPES

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

Authorized official

Name

Wilbur Gay

Title

Cfo

Phone

(864) 561-7672

Specialties & licenses 1

Addresses

Other names 1

• Bon Secours Mary Immaculate Hospital pro fee Other name

Part of

Invalid Entry

Locations

Practitioners 29

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.

• Susan Christine Clark, MD

  • Surgery Physician
  • Portsmouth, VA
  • NPI 1104096650
  NPD
• Apurva M Patel, MD, FACC

  • Cardiovascular Disease Physician
  • Suffolk, VA
  • NPI 1902856230
  NPD
• Kelly Oliver Spann, NP

  • Family Nurse Practitioner
  • Williamsburg, VA
  • NPI 1003990441
  NPD
• Dewey Steele, PA-C

  • Specialist
  • Newport News, VA
  • NPI 1174687131
  NPD
• Anthony Terracina, M.D.

  • Specialist
  • Newport News, VA
  • NPI 1144384199
  NPD
• Nicole Faye Yeshtokin, DO

  • Surgery Physician
  • South Boston, VA
  • NPI 1336371525
  NPD
• Hameed Jafri, M.D.

  • Surgery Physician
  • Nellis AFB, NV
  • NPI 1548589526
  NPD
• Roxanne Dietzler, DO

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1407928872
  NPD (past)
• Chester Lionel Fisher Jr., MD

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710159207
  NPD (past)
• Khalid M Hamid, MD

  • Internal Medicine Physician
  • Newport News, VA
  • NPI 1932189578
  NPD (past)
• Gloria M Jackson, M.D.

  • Family Medicine Physician
  • Grafton, VA
  • NPI 1235123423
  NPD (past)
• Vincent Thomas Joseph, DC

  • Chiropractor
  • Newport News, VA
  • NPI 1922038421
  NPD (past)

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1538535463",
    "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",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BERNARDINE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024404",
            "telephone_number": "757-398-2208",
            "fax_number": "757-398-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY IMMACULATE HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY IMMACULATE HOSPITAL LLC",
        "enumeration_date": "2015-08-14",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-561-7672"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Mary Immaculate Hospital pro fee",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bon Secours Mary Immaculate Hospital pro fee",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Immaculate Hospital (Bon Secours Pulmonary Specialists @ MIH)
• Mary Immaculate Hospital (Dba Bon Secours Vein and Vascular Specialists @ Mih)
• Mary Immaculate Hospital (Vascular Surgery)
• Mary Immaculate Hospital LLC (Bon Secours Surgical Specialists)
• Mary Immaculate Hospital LLC
• Mary Immaculate Hospital LLC (Bon Secours Palliative Medicine)
• Mary Immaculate Nursing Center LLC (Saint Francis Nursing Center)
• Maryview Hospital LLC (Bon Secours Liver Institute of Hampton Roads)
• Maryview Hospital LLC (Bon Secours Medical Oncology)
• Maryview Hospital LLC (Bon Secours Gynecologic Oncology Specialists)

• General Acute Care Hospital in Newport News, VA
• Providers in Newport News, VA by specialty
• General Acute Care Hospital in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.