Bon Secours Medical Group Hampton Roads Specialty Care LLC
Organization Active NPI Cardiovascular Disease Physician · Richmond, VA
NPI 1629637475 · NPPES record last updated Mar 11, 2026
Key facts
- NPI
- 1629637475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- Legal business name
- BON SECOURS MEDICAL GROUP HAMPTON ROADS SPECIALTY CARE LLC
- Practice address
- 8580 Magellan Pkwy
Richmond, VA 23227-1149 - Phone
- (804) 627-5573
- Fax
- (866) 449-0896
- NPI assigned
- Jun 6, 2019
- Organization subpart
- No
Authorized official
- Name
- Cassie Lowe
- Title
- System Director, Payer Delegation &
- Phone
- (513) 952-5210
Practitioners 430
-
Amutallah Abdussalaam, AGNP-C
-
David Daniel Alcantara, M.D.
-
Rachel Anglin, PA-C
-
Olumide Ayeni, MD
-
Mary S Baker, MD
-
Monica Rene' Beckett, AGACNP
-
Melanie Bjorkman, FNP-C
-
Myria Gunn Black, NP-C
-
Steven Charles Blasdell, M.D.
-
Lora C Blount, NP-C
-
Michael Andrew Caines, M.D.
-
William E. Callaghan, M.D.
-
Sarah Lynn Carbullido, RN, FNP-BC
-
Jun K. Chung, M.D.
-
Cedric Cole, MD
-
Scott Edward Colton, CRNA
-
Jordan Cox, AGACNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191122000258 | VA | Part B Supplier - Clinic/Group Practice | 3173955671 |
Receives reassigned benefits from 423 practitioners Practice locations: Suffolk, VA; Virginia Beach, VA; Portsmouth, VA; Chesapeake, VA; Emporia, VA; Franklin, VA; Newport News, VA; Norfolk, VA… |
National Provider Directory
Locations
930 W 21st St
#2
Norfolk, VA 23517
930 W 21st St
Ste 200
Norfolk, VA 23517
930 W 21st St
Fl 1
Norfolk, VA 23517
930 W 21st St
#1
Norfolk, VA 23517
3636 High St
Fl 6
Portsmouth, VA 23707
3640 High St
Ste 1E
Portsmouth, VA 23707
Phone (757) 398-2200
3636 High St
Ste 2D
Portsmouth, VA 23707
5818 Harbour View Blvd
Ste Bs
Suffolk, VA 23435
1020 Bon Secours Dr
Ste 240
Suffolk, VA 23435
Phone (757) 483-8268
7025 Harbour View Blvd
Ste 118
Suffolk, VA 23435
5838 Harbour View Blvd
Ste 108
Suffolk, VA 23435
5818 Harbour View Blvd
Ste 2
Suffolk, VA 23435
5818 Harbour View Blvd
Ste 105
Suffolk, VA 23435
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | Yes | ||
| Gastroenterology Physician |
207RG0100X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Medical Oncology Physician |
207RX0202X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Gynecologic Oncology Physician |
207VX0201X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Neurology Physician |
2084N0400X | |||
| Psychiatry Physician |
2084P0800X | |||
| Radiation Oncology Physician |
2085R0001X | |||
| Surgery Physician |
208600000X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | |||
| Pain Medicine Physician |
208VP0000X | |||
| Nurse Practitioner |
363L00000X | |||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
8580 Magellan Pkwy
Richmond, VA 23227-1149
Mailing address
4600 McAuley PL Ste 600
Blue Ash, OH 45242-4778
Other providers in Richmond, VA
- Bon Secours - Richmond Community Hospital, Incorporated
- Bon Secours - Richmond Community Hospital, Incorporated
- Bon Secours Ambulatory Services LLC
- Bon Secours Critical Care Transport LLC
- Bon Secours Medical Group Hampton Roads Primary Care LLC
- Bon Secours Medical Group Richmond Primary Care LLC
- Bon Secours Medical Group Richmond Specialty Care LLC
- Bon Secours Medical Group Richmond Specialty Care LLC
- Bon Secours Memorial Regional Medical Center
- Bon Secours Memorial Regional Medical Center
All providers in Richmond, VA · Cardiovascular Disease Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.