NPIMap

Organization Active NPI

Virginia Beach Surgery, LTD

  • Surgery Physician
  • Virginia Beach, VA
National Provider Identifier
1558614958
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
VIRGINIA BEACH SURGERY, LTD
Practice address
1020 First Colonial Rd
Virginia Beach, VA 23454-3002
Phone
(757) 481-2313
NPI assigned
Oct 23, 2012
Last updated
Oct 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Candace Martin
Title
Practice Manager
Phone
(757) 481-2313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary
Vascular Surgery Physician 2086S0129X

Addresses

Primary practice location

1020 First Colonial Rd
Virginia Beach, VA 23454-3002

Mailing address

PO Box 4159
Virginia Beach, VA 23454-0159
Phone (757) 481-2313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121217000014 VA Part B Supplier - Clinic/Group Practice 0749432920 Receives reassigned benefits from 3 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1558614958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4159",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234540159",
            "telephone_number": "757-481-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543002",
            "telephone_number": "757-481-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA BEACH SURGERY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "757-481-2313"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.