Bon Secours Memorial Regional Medical Center Inc
Organization Active NPI Family Medicine Physician · Mechanicsville, VA
NPI 1679957948 · NPPES record last updated Jul 11, 2019
Key facts
- NPI
- 1679957948
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC
- Practice address
- 8200 Meadowbridge Rd Ste 301
Mechanicsville, VA 23116-2337 - Phone
- (804) 442-3750
- Fax
- (804) 559-8535
- NPI assigned
- Jul 16, 2015
- Organization subpart
- No
Authorized official
- Name
- Stephan Quiriconi
- Title
- Cfo
- Phone
- (804) 281-8301
Other NPIs on the same Medicare enrollment 23
Practitioners 14
-
Kumar Abhishek, M.D.
-
Clarence G. Childress, M.D.
-
Arleeta M Diggs, MD
-
Wendy Evans, D.O.
-
Brian J Foster, MD
-
George Georges, MD
-
Douglas A Johnson, M.D.
-
Shenna R Keene, MD
-
George B Newton, MD
-
Sarah Weber, NP
-
Mary Fulcher Baker, FNP
-
Meghan Fusz Rodden, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040726000687 | VA | Part B Supplier - Clinic/Group Practice | 6507775293 |
Receives reassigned benefits from 75 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kilmarnock, VA; Glen Allen, VA; Richmond, VA; Mechanicsville, VA; King William, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
8200 Meadowbridge Rd Ste 301
Mechanicsville, VA 23116-2337
Mailing address
8580 Magellan Pkwy
Richmond, VA 23227-1149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C06115 | Other | VA | GROUP PTAN |
Other names
- Hanover County and Bon Secours Good Health Clinic
Other providers in Mechanicsville, VA
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center Inc
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours Memorial Regional Medical Center LLC
- Bon Secours Memorial Regional Medical Center LLC
All providers in Mechanicsville, VA · Family Medicine 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 Jul 11, 2019. 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.