NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Family & Internal Medicine Physicians

  • Family Medicine Physician
  • Elizabeth City, NC
National Provider Identifier
1760717763
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Family & Internal Medicine Physicians
Practice address
1507 N Road St
Ste 200
Elizabeth City, NC 27909-3282
Phone
(252) 337-9190
Fax
(252) 338-6503
NPI assigned
Oct 8, 2009
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

1507 N Road St
Ste 200
Elizabeth City, NC 27909-3282

Mailing address

1507 N Road St
Ste 200
Elizabeth City, NC 27909-3282
Phone (252) 337-9190

Other identifiers 1

IdentifierTypeStateIssuer
232011OtherNCMEDICARE GROUP NUMBER

Other names 1

  • Sentara Family & Internal Medicine Physicians Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seisentra Hlthcare Ctr188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 5

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

Locations

1507 N Road St
Ste 200
Elizabeth City, NC 27909
Phone (252) 337-9190

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1760717763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 N ROAD ST",
            "address_2": "STE 200",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093282",
            "telephone_number": "252-337-9190",
            "fax_number": "252-338-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 N ROAD ST",
            "address_2": "STE 200",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093282",
            "telephone_number": "252-337-9190",
            "fax_number": "252-338-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-08",
        "last_updated": "2015-07-31",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "232011",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Family & Internal Medicine Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.