Chesapeake Hospital Corporation
Organization Active NPI Family Medicine Physician · Heathsville, VA
NPI 1770073025 · NPPES record last updated May 30, 2019
Key facts
- NPI
- 1770073025
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHESAPEAKE HOSPITAL CORPORATION
- Practice address
- 8152 Northumberland Hwy
Heathsville, VA 22473-3309 - Phone
- (804) 580-7200
- Fax
- (804) 580-7063
- NPI assigned
- May 12, 2018
- Organization subpart
- No
Authorized official
- Name
- Stephan Quiriconi
- Title
- Cfo
- Phone
- (804) 281-8301
Other NPIs on the same Medicare enrollment 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041027001018 | VA | Part B Supplier - Clinic/Group Practice | 8921060427 |
Receives reassigned benefits from 20 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kilmarnock, VA; Lively, VA; Heathsville, VA; Hartfield, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
8152 Northumberland Hwy
Heathsville, VA 22473-3309
Mailing address
8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5573
Other names
- Bon Secours Heathsville Family Practice
Other providers in Heathsville, VA
- Blackwell Transportation
- Ira Blackwell
- Breakingforth Transportation LLC
- Thomas E Burke Jr.
- C&C Medical Equipment & Supplies, LLC
- Chesapeake Hospital LLC
- Chesapeake Medical Group, Inc.
- Janis Clark
- Lakiko Cockrell
- Commonweatlh of Virginia State Board of Health
All providers in Heathsville, 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 May 30, 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.