Individual provider Active NPI

Robert Anthony Frazier Jr., M.D.

  • Dermatopathology (Pathology) Physician
  • Norfolk, VA
National Provider Identifier
1659329902
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
0101055418 Issued in VA
Practice address
733 Boush St
Suite 200
Norfolk, VA 23510-1501
Phone
(757) 664-7901
Fax
(757) 664-9122
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 0101055418 VA Primary

Addresses

Primary practice location

733 Boush St
Suite 200
Norfolk, VA 23510-1501

Mailing address

PO Box 2453
Norfolk, VA 23501-2453
Phone (757) 664-7901

Other identifiers 1

IdentifierTypeStateIssuer
004991427MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140227002149 VA Order and Referring Only - PathologyPractitioner - Pathology 6507906617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101055418VAMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Pathologists LTD Current Accepting new patients
Dominion Pathology Laboratories PC PastSince Nov 18, 2009 Accepting new patients

Locations

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1659329902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2453",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235012453",
            "telephone_number": "757-664-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 BOUSH ST",
            "address_2": "SUITE 200",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101501",
            "telephone_number": "757-664-7901",
            "fax_number": "757-664-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "VA",
            "license": "0101055418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004991427",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.