NPIMap

Organization Active NPI

Chesapeake Center for Cosmetic and Plastic Surgery PC

  • Specialist
  • Suffolk, VA
National Provider Identifier
1851517379
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101041085 Issued in VA
Legal business name
CHESAPEAKE CENTER FOR COSMETIC AND PLASTIC SURGERY PC
Practice address
5818 Harbour View Blvd
Suffolk, VA 23435-3315
Phone
(757) 673-5900
Fax
(757) 673-5905
NPI assigned
Apr 17, 2007
Last updated
Feb 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Dr. Tad E. Grenga, M.D.NPI 1124009253
Title
Director
Phone
(757) 673-5900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101041085 VA Primary

Addresses

Primary practice location

5818 Harbour View Blvd
Suffolk, VA 23435-3315

Mailing address

5818 Harbour View Blvd
Suffolk, VA 23435-3315
Phone (757) 673-5900

Other identifiers 3

IdentifierTypeStateIssuer
6901395MedicaidVA
118152OtherVABLUE CROSS
15906OtherVAOPTIMASENTARA

National Provider Directory

National Provider Directory

Locations

5818 Harbour View Blvd
#220
Suffolk, VA 23435
Phone (757) 673-5900

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1851517379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-673-5900",
            "fax_number": "757-673-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353315",
            "telephone_number": "757-673-5900",
            "fax_number": "757-673-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE CENTER FOR COSMETIC AND PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "GRENGA",
        "authorized_official_first_name": "TAD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-673-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101041085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6901395",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "118152",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMASENTARA",
            "identifier": "15906",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.