Individual provider Active NPI

John Richard Sweeney II, M.D.

  • Allergy & Immunology Physician
  • Suffolk, VA
National Provider Identifier
1790788065
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101031033 Issued in VA
Practice address
2453 Pruden Blvd
Suffolk, VA 23434-4235
Phone
(757) 539-7771
Fax
(757) 539-4360
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 0101031033 VA Primary

Addresses

Primary practice location

2453 Pruden Blvd
Suffolk, VA 23434-4235

Mailing address

111 Riverside Drive
Suffolk, VA 23435
Phone (757) 638-3780

Other identifiers 1

IdentifierTypeStateIssuer
6009476MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100830000417 VA Practitioner - Allergy/Immunology 9638241516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Past Accepting new patients
James C. Larocque Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1790788065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 RIVERSIDE DRIVE",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-638-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2453 PRUDEN BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344235",
            "telephone_number": "757-539-7771",
            "fax_number": "757-539-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101031033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6009476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.