Individual provider Active NPI

Ronald Kirkland Sallas, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Norfolk, VA
National Provider Identifier
1578500617
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
0101057171 Issued in VA
Practice address
601 Childrens LN
Norfolk, VA 23507-1910
Phone
(757) 668-7007
Fax
(757) 668-8658
NPI assigned
May 31, 2006
Last updated
Apr 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101057171 VA
Pediatrics Physician 208000000X 0101057171 VA
Neonatal-Perinatal Medicine Physician 2080N0001X 0101057171 VA Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 0101057171 VA

Addresses

Primary practice location

601 Childrens LN
Norfolk, VA 23507-1910

Mailing address

PO Box 79137
Baltimore, MD 21279-0137
Phone (757) 668-7200

Other identifiers 5

IdentifierTypeStateIssuer
3810001092MedicaidWV
006704948MedicaidVA
0019058700001MedicaidPA
89063CFMedicaidNC
403589500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000263 VA Practitioner - Pediatric Medicine 2062407422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101057171VAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Oct 1, 2014 Accepting new patients

Locations

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1578500617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79137",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790137",
            "telephone_number": "757-668-7200",
            "fax_number": "757-668-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CHILDRENS LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071910",
            "telephone_number": "757-668-7007",
            "fax_number": "757-668-8658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLAS",
        "first_name": "RONALD",
        "middle_name": "KIRKLAND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101057171",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101057171",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "VA",
            "license": "0101057171",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "0101057171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001092",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006704948",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019058700001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89063CF",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403589500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.