Bon Secours Depaul Medical Center LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

BON SECOURS DEPAUL MEDICAL CENTER LLC

Practice address

150 Kingsley LN
Norfolk, VA 23505-4602

Phone

(757) 889-5155

Fax

(757) 889-4127

NPI assigned

Dec 11, 2006

Last updated

Sep 21, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

BON SECOURS DEPAUL MEDICAL CENTER LLCAs reported in NPPES

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

Authorized official

Name

Wilbur Gay

Title

Cfo

Phone

(864) 561-7672

Specialties & licenses 1

Addresses

Other names 1

• Bon Secours DePaul Medical Center CRNA Other name

Part of

Depaul Medical Ctr

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1770643835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KINGSLEY LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054602",
            "telephone_number": "757-889-5155",
            "fax_number": "757-889-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS DEPAUL MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS DEPAUL MEDICAL CENTER LLC",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "WILBUR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-561-7672"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours DePaul Medical Center CRNA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bon Secours Depaul Medical Center Inc (Bon Secours Neurovascular Center)
• Bon Secours Depaul Medical Center Inc (DePaul Palliative Program)
• Bon Secours Depaul Medical Center Inc. (Virginia Orthopaedic & Spine Specialists)
• Bon Secours Depaul Medical Center LLC
• Bon Secours Depaul Medical Center LLC (DePaul Medical Associates)
• Bon Secours Eap
• Bon Secours Private Care
• Naomi Bond, LMT
• Dmitry Bondarenko, MD
• Sarah Bondurant, CCC-SLP

• Certified Registered Nurse Anesthetist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Certified Registered Nurse Anesthetist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.