NPIMap

Organization Active NPI

Bon Secours-Virginia Healthsource

  • Family Medicine Physician
  • Chester, VA
National Provider Identifier
1629185293
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BON SECOURS-VIRGINIA HEALTHSOURCE
Practice address
11601 Iron Bridge Rd
Suite 117
Chester, VA 23831
Phone
(804) 717-5300
Fax
(804) 748-7269
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Authorized official

Name
George O. Butler, MBA
Title
Director, Physician Credentialing
Phone
(804) 281-0271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11601 Iron Bridge Rd
Suite 117
Chester, VA 23831

Mailing address

11601 Iron Bridge Rd
Suite 117
Chester, VA 23831-1466
Phone (804) 717-5300

Other names 1

  • Richmond Radiation Oncology Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaverdam Family Phy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1629185293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 IRON BRIDGE RD",
            "address_2": "SUITE 117",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311466",
            "telephone_number": "804-717-5300",
            "fax_number": "804-748-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 IRON BRIDGE RD",
            "address_2": "SUITE 117",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "23831",
            "telephone_number": "804-717-5300",
            "fax_number": "804-748-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN CREDENTIALING",
        "authorized_official_telephone_number": "804-281-0271",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richmond Radiation Oncology Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Richmond Radiation Oncology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.