NPIMap

Organization Active NPI

Bon Secours Depaul Medical Center Inc

  • Neurology Physician
  • Norfolk, VA
National Provider Identifier
1881983278
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BON SECOURS DEPAUL MEDICAL CENTER INC
Practice address
110 Kingsley LN
Suite 411
Norfolk, VA 23505-4614
Phone
(757) 889-5040
Fax
(757) 889-5041
NPI assigned
Apr 6, 2011
Organization subpart
Yes
Parent organization
BON SECOURS DEPAUL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Stephan Quiriconi
Title
Cfo
Phone
(804) 281-8301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

110 Kingsley LN
Suite 411
Norfolk, VA 23505-4614

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5462

Other names 1

  • Bon Secours Neurovascular Center Doing business as

National Provider Directory

National Provider Directory
Part of
Bon Secours Depaul Med Ctr

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1881983278",
    "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",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 411",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-889-5040",
            "fax_number": "757-889-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS DEPAUL MEDICAL CENTER INC",
        "enumeration_date": "2011-04-06",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Neurovascular Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours Neurovascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.