NPIMap

Organization Active NPI

Greater Suffolk Medical Center

  • Internal Medicine Physician
  • Suffolk, VA
National Provider Identifier
1619016284
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101033710 Issued in VA
Legal business name
GREATER SUFFOLK MEDICAL CENTER
Practice address
114 N Main St Ste 200
Suffolk, VA 23434-4564
Phone
(757) 934-1003
Fax
(757) 934-1660
NPI assigned
Feb 6, 2007
Last updated
Apr 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Authorized official

Name
Dr. Michael T Williams, MDNPI 1093868424
Title
President
Phone
(757) 934-1003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101033710 VA Primary

Addresses

Primary practice location

114 N Main St Ste 200
Suffolk, VA 23434-4564

Mailing address

114 N Main St Ste 200
Suffolk, VA 23434-4564
Phone (757) 934-1003

Other identifiers 13

IdentifierTypeStateIssuer
6068286MedicaidVI
7360720MedicaidNC
095436OtherVABLUE CROSS
77906536MedicaidNC
12104OtherVAOPTIMA
7906203MedicaidNC
890658EMedicaidNC
110007205MedicaidVA
12068OtherVAOPTIMA
45055OtherVAOPTIMA
5813735MedicaidVI
041021OtherVABLUE CROSS
13762OtherVAOPTIMA

National Provider Directory

National Provider Directory

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": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1619016284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N MAIN ST STE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344564",
            "telephone_number": "757-934-1003",
            "fax_number": "757-934-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N MAIN ST STE 200",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344564",
            "telephone_number": "757-934-1003",
            "fax_number": "757-934-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SUFFOLK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-934-1003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101033710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6068286",
            "state": "VI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7360720",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "095436",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77906536",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "12104",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7906203",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890658E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110007205",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "12068",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "45055",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5813735",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "041021",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "13762",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; 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.