Organization Active NPI

Bayside Internal Medicine PLC

  • Internal Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1851481154
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BAYSIDE INTERNAL MEDICINE PLC
Practice address
1020 Independence Blvd
Suite 105
Virginia Beach, VA 23455-5500
Phone
(757) 318-3700
Fax
(757) 318-3701
NPI assigned
Oct 15, 2006
Last updated
May 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Mrs. Starr Nichols, CPC
Title
Billing Manager
Phone
(757) 363-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1020 Independence Blvd
Suite 105
Virginia Beach, VA 23455-5500

Mailing address

1020 Independence Blvd
Suite 105
Virginia Beach, VA 23455-5500
Phone (757) 318-3700

Other identifiers 1

IdentifierTypeStateIssuer
CB3911OtherVAMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Locations

1020 Independence Blvd
Ste 105
Virginia Beach, VA 23455
Phone (757) 318-3700

1020 Independence Blvd
Ste 311
Virginia Beach, VA 23455
Phone (757) 318-3700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1851481154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 INDEPENDENCE BLVD",
            "address_2": "SUITE 105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555500",
            "telephone_number": "757-318-3700",
            "fax_number": "757-318-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 INDEPENDENCE BLVD",
            "address_2": "SUITE 105",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555500",
            "telephone_number": "757-318-3700",
            "fax_number": "757-318-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE INTERNAL MEDICINE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-15",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "STARR",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "757-363-3001",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB3911",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.