NPIMap

Organization Active NPI

Bon Secours-St. Mary's Hospital of Richmond, Inc.

Doing business as Bon Secours Palliative Medicine

  • Geriatric Medicine (Internal Medicine) Physician
  • Richmond, VA
National Provider Identifier
1598782187
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Doing business as
Bon Secours Palliative Medicine
Practice address
8580 Magellan Pkwy
Building IV - Palliative Care Services
Richmond, VA 23227-1149
Phone
(804) 627-5291
Fax
(804) 627-5360
NPI assigned
Jul 17, 2006
Last updated
Aug 30, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Authorized official

Name
Stephan Quiriconi
Title
Cfo
Phone
(804) 281-8301

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

8580 Magellan Pkwy
Building IV - Palliative Care Services
Richmond, VA 23227-1149

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149

Other identifiers 2

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN
DD4686OtherVARAILROAD MEDICARE

Other names 1

  • Bon Secours Palliative Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000566 VA Part B Supplier - Clinic/Group Practice 8527969476 Receives reassigned benefits from 159 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Richmond, VA; Midlothian, VA; Mechanicsville, VA; Chester, VA; Blackstone, VA

Other NPIs on the same Medicare enrollment 48

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 48

National Provider Directory

National Provider Directory
Part of
Bon Secours St Marys Hosp

Locations

8580 Magellan Pkwy
Bldg Iv
Richmond, VA 23227
Phone (804) 627-5291

Practitioners & affiliated clinicians

Practitioners 3

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1598782187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "address_2": "BUILDING IV - PALLIATIVE CARE SERVICES",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-627-5291",
            "fax_number": "804-627-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD4686",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Palliative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours Palliative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.