NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Surgery Specialists

  • Surgery Physician
  • Stafford, VA
National Provider Identifier
1689958860
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Surgery Specialists
Practice address
95 Dunn Dr Ste 123
Stafford, VA 22556-1503
Phone
(703) 523-9550
Fax
(540) 699-2584
NPI assigned
Oct 5, 2011
Last updated
Apr 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Mrs. Doris Prince
Title
Director
Phone
(757) 983-5475

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

95 Dunn Dr Ste 123
Stafford, VA 22556-1503

Mailing address

95 Dunn Dr Ste 123
Stafford, VA 22556-1503
Phone (703) 523-9550

Other practice location 1

2761 Jefferson Davis Hwy
Ste 207
Stafford, VA 22554-8329
Phone (540) 657-8180

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

Other names 1

  • Sentara Surgery Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Int Medi188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1689958860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 DUNN DR STE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561503",
            "telephone_number": "703-523-9550",
            "fax_number": "540-699-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 DUNN DR STE 123",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225561503",
            "telephone_number": "703-523-9550",
            "fax_number": "540-699-2584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2761 Jefferson Davis Hwy",
            "address_2": "Ste 207",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225548329",
            "country_code": "US",
            "telephone_number": "540-657-8180",
            "fax_number": "571-589-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-983-5475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Surgery Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Surgery Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.