Tri City Surgical Associates

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

TRI CITY SURGICAL ASSOCIATES

Practice address

930 South Ave
Suite 4 a
Colonial Heights, VA 23834-3621

Phone

(804) 524-2294

Fax

(804) 524-0016

NPI assigned

Sep 22, 2006

Last updated

Jun 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth M Ford

Title

Office Practice Assistant

Phone

(804) 524-2294

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 2

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.

• Kristina Benton

  • Physician Assistant
  • Colonial Heights, VA
  • NPI 1255192316
  NPD (past)
• Vilok Vijayanagar, D.O.

  • Surgery Physician
  • Colonial Heights, VA
  • NPI 1942681952
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1548369796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 SOUTH AVE",
            "address_2": "SUITE 4 A",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343621",
            "telephone_number": "804-524-2294",
            "fax_number": "804-524-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SOUTH AVE",
            "address_2": "SUITE 4 A",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238343621",
            "telephone_number": "804-524-2294",
            "fax_number": "804-524-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CITY SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE PRACTICE ASSISTANT",
        "authorized_official_telephone_number": "804-524-2294",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "027707",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "051145",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "110950",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007385382",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007301201",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007305826",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tri Cities Counseling Services LLC
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• Lucy Kelechi Ukachukwu
• Amber A Underhill, MED

• Specialist in Colonial Heights, VA
• Providers in Colonial Heights, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.