Individual provider Active NPI

Marc William Flickinger, M.D.

  • Family Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1588652812
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101242318 Issued in VA
Practice address
500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone
(434) 654-7580
Fax
(434) 654-7582
NPI assigned
Oct 11, 2005
Last updated
Dec 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101242318 VA Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 0101242318 VA

Addresses

Primary practice location

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668

Mailing address

PO Box 75268
Baltimore, MD 21275-5268
Phone (434) 654-7794

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
I20080715000277 VA Practitioner - Internal MedicinePractitioner - Family Practice 5395785612 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101242318VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Mar 14, 2016 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC Family Medicine CurrentSince Mar 14, 2016 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients

Locations

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

7229 Forest Ave
Ste 112
Richmond, VA 23226
Phone (804) 281-0275

Organizations & group practices 5

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1588652812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75268",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212755268",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICKINGER",
        "first_name": "MARC",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101242318",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0101242318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.