NPIMap

Organization Active NPI

Bon Secours Depaul Medical Center Inc

  • Surgery Physician
  • Norfolk, VA
National Provider Identifier
1598998569
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BON SECOURS DEPAUL MEDICAL CENTER INC
Doing business as
Bon Secours Surgical Specialists
Practice address
155 Kingsley LN Ste 405
Norfolk, VA 23505-4629
Phone
(757) 278-2220
Fax
(757) 489-0701
NPI assigned
Aug 25, 2009
Organization subpart
Yes
Parent organization
BON SECOURS DEPAUL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

155 Kingsley LN Ste 405
Norfolk, VA 23505-4629

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5462

Other names 1

  • Bon Secours Surgical Specialists Doing business as

National Provider Directory

National Provider Directory
Part of
Bon Secours Depaul Med Ctr

Locations

12720 McManus Blvd
Ste 308
Newport News, VA 23602
Phone (757) 947-3170

5875 Bremo Rd
Ste 212
Richmond, VA 23226
Phone (804) 249-8888

1009 Centerbrooke Ln
Ste 208
Suffolk, VA 23434

1002 Bon Secours Dr
Suffolk, VA 23435
Phone (757) 541-1110

828 Healthy Way
Ste 200
Virginia Beach, VA 23462
Phone (757) 309-4715

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1598998569",
    "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",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 KINGSLEY LN STE 405",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054629",
            "telephone_number": "757-278-2220",
            "fax_number": "757-489-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "enumeration_date": "2009-08-25",
        "last_updated": "2019-05-16",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.