NPIMap

Organization Active NPI

Sentara Medical Group

  • Occupational Medicine Physician
  • Suffolk, VA
National Provider Identifier
1548629322
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
SENTARA MEDICAL GROUP
Practice address
3920 A Bridge Rd
Ste 305
Suffolk, VA 23435-1126
Phone
(757) 983-0080
Fax
(757) 983-0019
NPI assigned
Feb 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083X0100X VA Primary

Addresses

Primary practice location

3920 A Bridge Rd
Ste 305
Suffolk, VA 23435-1126

Mailing address

3920 Bridge Rd Ste 305
Suffolk, VA 23435-1107
Phone (757) 983-0080

Other practice location 1

3920 A Bridge Rd
Ste 305
Suffolk, VA 23435-1126
Phone (757) 983-0080

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Old Hampton Family Prac188 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

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1548629322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 BRIDGE RD STE 305",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351107",
            "telephone_number": "757-983-0080",
            "fax_number": "757-983-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 A BRIDGE RD",
            "address_2": "STE 305",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351126",
            "telephone_number": "757-983-0080",
            "fax_number": "757-983-0019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 A Bridge Rd",
            "address_2": "Ste 305",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234351126",
            "country_code": "US",
            "telephone_number": "757-983-0080",
            "fax_number": "757-983-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2018-04-11",
        "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": "2083X0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.