NPIMap

Organization Active NPI

Sentara Medical Group

  • Family Medicine Physician
  • Suffolk, VA
National Provider Identifier
1710318241
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SENTARA MEDICAL GROUP
Practice address
2760 Godwin Blvd Ste 100
Suffolk, VA 23434-8036
Phone
(757) 983-8650
Fax
(757) 983-8673
NPI assigned
Dec 10, 2013
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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) 252-2765

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

2760 Godwin Blvd Ste 100
Suffolk, VA 23434-8036

Mailing address

2760 Godwin Blvd Ste 100
Suffolk, VA 23434-8036
Phone (757) 983-8650

Other practice location 1

2050 Hillpoint Blvd N
Suffolk, VA 23434-7181
Phone (757) 983-8650

Other identifiers 1

IdentifierTypeStateIssuer
C02033OtherVAMEDICARE GROUP NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Invalid Entry188 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

Locations

2050 Hillpoint Blvd N
Suffolk, VA 23434
Phone (757) 290-6190

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1710318241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348036",
            "telephone_number": "757-983-8650",
            "fax_number": "757-538-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348036",
            "telephone_number": "757-983-8650",
            "fax_number": "757-983-8673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 Hillpoint Blvd N",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234347181",
            "country_code": "US",
            "telephone_number": "757-983-8650",
            "fax_number": "757-538-9038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2018-03-17",
        "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": "757-252-2765",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C02033",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.