Active NPI
Mark Edwin Deblois, M.D.
- Orthopaedic Surgery Physician
- North Chesterfield, VA
National Provider Identifier
1548214372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 0101036512
- Practice address
- 1115 Boulders Pkwy
Suite 100
North Chesterfield, VA 23225-4067 - Phone
- (804) 320-1339
- Fax
- (804) 330-5829
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | 101036512 | VA | |
| Orthopaedic Surgery Physician | 207X00000X | 0101036512 | VA | Primary |
Addresses
Primary practice location
1115 Boulders Pkwy
Suite 100
North Chesterfield, VA 23225-4067
Mailing address
1115 Boulders Pkwy
Suite 200
North Chesterfield, VA 23225-4067
Phone (804) 560-5595
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061547 | Other | VA | ANTHEM HEALTHKEEPERS PLUS |
| 061547 | Other | VA | ANTHEM |
| 540885859 | Other | VA | C&O EMPLOYEES HOSP ASSO |
| 540885859 | Other | VA | FARA |
| 006440193 | Medicaid | VA | |
| 2138265 | Other | VA | UNITED HEALTH CARE MAMSI |
| 540885859 | Other | VA | FOCUS |
| 540885859 | Other | VA | MULTIPLAN |
| 540885859 | Other | VA | CENVANET |
| 1548214372 | Medicaid | VA | |
| 536767 | Other | VA | AETNA/US HMO |
| 540885859 | Other | VA | PHCS |
| 540885859 | Other | VA | CIGNA |
| 540885859 | Other | VA | COMPMANAGEMENT |
| 200019198 | Other | VA | RR MEDICARE |
| 48192 | Other | VA | OPTIMA HEALTH |
| 540885859 | Other | VA | CORVEL |
| 540885859 | Other | VA | FIRST HEALTH/CCN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101036512 | VA | MD | Orthopaedic Surgery Physician |
| 101036512 | VA | MD | Adult Reconstructive Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1548214372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 BOULDERS PKWY",
"address_2": "SUITE 200",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232254067",
"telephone_number": "804-560-5595",
"fax_number": "804-560-9029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 BOULDERS PKWY",
"address_2": "SUITE 100",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232254067",
"telephone_number": "804-320-1339",
"fax_number": "804-330-5829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBLOIS",
"first_name": "MARK",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "VA",
"license": "101036512",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "VA",
"license": "0101036512",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTHKEEPERS PLUS",
"identifier": "061547",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "061547",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "C&O EMPLOYEES HOSP ASSO",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FARA",
"identifier": "540885859",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006440193",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE MAMSI",
"identifier": "2138265",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOCUS",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CENVANET",
"identifier": "540885859",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1548214372",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/US HMO",
"identifier": "536767",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPMANAGEMENT",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200019198",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH",
"identifier": "48192",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "540885859",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH/CCN",
"identifier": "540885859",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Chesterfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.