NPIMap

Organization Active NPI

Mary Immaculate Hospital

Doing business as Dba Bon Secours Vein and Vascular Specialists @ Mih

  • Vascular Surgery Physician
  • Newport News, VA
National Provider Identifier
1689047979
Registry record updated Nov 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MARY IMMACULATE HOSPITAL
Doing business as
Dba Bon Secours Vein and Vascular Specialists @ Mih
Practice address
12720 McManus Blvd
Suite 203
Newport News, VA 23602-4414
Phone
(757) 397-2383
Fax
(757) 673-0236
NPI assigned
Nov 9, 2015
Last updated
Nov 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2015

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

Authorized official

Name
Karen A Smith
Title
Credentialing Specialist
Phone
(757) 215-2784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

12720 McManus Blvd
Suite 203
Newport News, VA 23602-4414

Mailing address

7007 Harbour View Blvd
Suite 108
Suffolk, VA 23435-3657
Phone (757) 215-2784

Other names 1

  • DBA BON SECOURS VEIN AND VASCULAR SPECIALISTS @ MIH Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1689047979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 HARBOUR VIEW BLVD",
            "address_2": "SUITE 108",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353657",
            "telephone_number": "757-215-2784",
            "fax_number": "757-215-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 MCMANUS BLVD",
            "address_2": "SUITE 203",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024414",
            "telephone_number": "757-397-2383",
            "fax_number": "757-673-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY IMMACULATE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-215-2784"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA BON SECOURS VEIN AND VASCULAR SPECIALISTS @ MIH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.