NPIMap

Organization Active NPI

Sentara Medical Group

  • Diagnostic Radiology Physician
  • Williamsburg, VA
National Provider Identifier
1639357239
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
49D1080933 Issued in VA
Legal business name
SENTARA MEDICAL GROUP
Practice address
4374 New Town Ave
Suite 104
Williamsburg, VA 23188-2865
Phone
(757) 259-1335
Fax
(757) 259-1395
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Authorized official

Name
Mrs. Cindy A Taylor
Title
Manager
Phone
(757) 252-3344

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 49D1080933 VA Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

4374 New Town Ave
Suite 104
Williamsburg, VA 23188-2865

Mailing address

4374 New Town Ave
Suite 104
Williamsburg, VA 23188-2865
Phone (757) 259-1335

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • New Town Diagnostic Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1639357239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE",
            "address_2": "SUITE 104",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-259-1335",
            "fax_number": "757-259-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 NEW TOWN AVE",
            "address_2": "SUITE 104",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882865",
            "telephone_number": "757-259-1335",
            "fax_number": "757-259-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "757-252-3344",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "49D1080933",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Town Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.