Ellen T Fleenor, MD
Individual provider Active NPI Family Medicine Physician · Charles City, VA
NPI 1790763035 · NPPES record last updated Oct 16, 2012
Key facts
- NPI
- 1790763035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0101056487 (VA)
- Practice address
- 9950 Courthouse Rd
Charles City, VA 23030-3434 - Phone
- (804) 829-6600
- Fax
- (804) 829-6182
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Virginia School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Virginia Health Services Inc
Practice addresses (Care Compare)
9950 Courthouse Rd
Charles City, VA 23030-3434
Phone (804) 829-6600
Hospital & facility affiliations
- Bon Secours Southside Medical Center
- John Randolph Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051011001185 | VA | Practitioner - Family Practice | 3577588243 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101056487 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Virginia Health Services Inc | Current |
Accepting new patients | |
| Central Virginia Health Services Inc | Current |
Accepting new patients | |
| Central Virginia Health Services Inc | Current | Accepting new patients | |
| Central Virginia Health Services Inc | Past | Accepting new patients | |
| Vernon J Harris East End Community Health Center | Past | Accepting new patients |
Locations
9950 Courthouse Rd
Charles City, VA 23030
Phone (804) 226-6383
25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271
321 Poplar Dr
Ste C
Petersburg, VA 23805
Phone (804) 733-5591
3101 Johnson Rd
Petersburg, VA 23805
Phone (804) 861-4884
25 S Union St
Petersburg, VA 23803
Phone (804) 957-9601
4260 Crossings Blvd
Prince George, VA 23875
Phone (804) 452-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101056487 | VA | Yes |
Addresses
Primary practice location
9950 Courthouse Rd
Charles City, VA 23030-3434
Mailing address
9950 Courthouse Rd
Charles City, VA 23030-3434
Phone (804) 829-6600
Other providers in Charles City, VA
- Central Virginia Health Services Inc
- Charles City County Board of Supervisors
- Charles City County Public Schools
- Commonwealth of Virginia State Board of Health
- Devil Dog Ranch
- Karen E Fox
- Paige Hennis
- Indian Health Service Richmond Service Unit
- Indian Health Service Richmond Service Unit
- Joy Johns
All providers in Charles City, 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 Oct 16, 2012. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.