NPIMap

Organization Active NPI

Potomac Hospital Corporation of Prince William

Doing business as Sentara Northern Virginia Medical Center

  • General Acute Care Hospital
  • Woodbridge, VA
National Provider Identifier
1548366404
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H1771 Issued in VA
Legal business name
POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM
Doing business as
Sentara Northern Virginia Medical Center
Practice address
2300 Opitz Blvd
Patient Financial Services
Woodbridge, VA 22191-3311
Phone
(703) 670-1595
Fax
(703) 670-3267
NPI assigned
Sep 16, 2006
Last updated
Dec 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SENTARA HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Melinda Summerlin Hancock
Title
Cfo
Phone
(757) 455-7458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1771 VA Primary

Addresses

Primary practice location

2300 Opitz Blvd
Patient Financial Services
Woodbridge, VA 22191-3311

Mailing address

2300 Opitz Blvd
Patient Financial Services
Woodbridge, VA 22191-3311
Phone (703) 670-1595

Other identifiers 3

IdentifierTypeStateIssuer
4901134MedicaidVA
000028OtherVAANTHEM BCBS
293165OtherVAANTHEM HCFA

Other names 1

  • Sentara Northern Virginia Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://urldefense.proofpoint.com/v2/url?u=https-3A__cobiusconnect.cobius.com-3A8291_Gateway_Documen Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031004000007 VA Part A Provider - Hospital 3173435112 Practice locations: Dumfries, VA; Woodbridge, VA; Stafford, VA; Lorton, VA; Lake Ridge, VA; Alexandria, VA; Springfield, VA; Manassas, VA…
O20200122000004 VA Part B Supplier - Clinic/Group Practice 3173435112 Receives reassigned benefits from 3 practitioners
Practice locations: Dumfries, VA; Woodbridge, VA
O20241011001340 VA Part B Supplier - Intensive Cardiac Rehabilitation 3173435112 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbridge, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548366404. Details of each certification follow.

Hospital certification: CCN 490113

Legal name
POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM
Doing business as
SENTARA NORTHERN VIRGINIA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Nov 7, 1972
Last certification
Mar 5, 2013
Beds
183 (153 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 1968 in VA
Enrollment address
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Sentara Northern Virginia Medical CenterCCN 490113 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0223723Sentara Northern Virginia Medical Center2300 Opitz Blvd, Woodbridge, VA 22191AccreditationFeb 8, 2027

National Provider Directory

National Provider Directory
Part of
Port Warwick Medical Arts

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

12825 Minnieville Rd
Ste 100
Lake Ridge, VA 22192
Phone (703) 523-9800

2280 Opitz Blvd
Unit 1
Woodbridge, VA 22191
Phone (703) 523-1450

2296 Opitz Blvd
Ste 130
Woodbridge, VA 22191
Phone (703) 523-0660

4564 Daisy Reid Ave
Ste 215
Woodbridge, VA 22192
Phone (757) 282-4013

4565 Daisy Reid Ave
Ste 215
Woodbridge, VA 22192
Phone (703) 523-8750

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melinda Hancock Individual Corporate DirectorEvp & Cfo Jan 1, 2025
W-2 Managing Employee Jan 1, 2025
Dennis Matheis Individual Corporate Officer Sep 1, 2022
Corporate Director Sep 1, 2022
W-2 Managing EmployeePresident/Ceo Sep 1, 2022
Kathie Johnson Individual W-2 Managing EmployeePresident, Snvmc Dec 5, 2016
Eric Conley Individual Corporate Officer Apr 29, 2024
Corporate Director Apr 29, 2024
W-2 Managing Employee Apr 29, 2024
Michael D Lubeley Individual Corporate DirectorVice Chairman Nov 17, 2014
Mary Michos Individual Corporate Director Oct 1, 2010
W-2 Managing Employee Oct 1, 2010
Michelle L Allen Individual W-2 Managing EmployeePatient Accounts Manager Oct 28, 2022
Cathy W Darden Individual W-2 Managing Employee May 3, 2019
Amanda Noll Shepherd Individual W-2 Managing Employee Feb 25, 2013
Sentara Health Organization, Norfold, VA Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2009 100%
Carol S Shapiro Individual Corporate Director Oct 1, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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.

Affiliated clinicians 485

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 485

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1548366404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 OPITZ BLVD",
            "address_2": "PATIENT FINANCIAL SERVICES",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "703-670-1595",
            "fax_number": "703-670-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 OPITZ BLVD",
            "address_2": "PATIENT FINANCIAL SERVICES",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "703-670-1595",
            "fax_number": "703-670-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC HOSPITAL CORPORATION OF PRINCE WILLIAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SENTARA HEALTHCARE",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "SUMMERLIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-455-7458"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "H1771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4901134",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000028",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM HCFA",
            "identifier": "293165",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://urldefense.proofpoint.com/v2/url?u=https-3A__cobiusconnect.cobius.com-3A8291_Gateway_Documen",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sentara Northern Virginia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Northern Virginia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.