NPIMap

Organization Active NPI

Sentara Medical Group

Doing business as Sentara Surgery Specialists

  • Surgery Physician
  • Gloucester, VA
National Provider Identifier
1902404296
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SENTARA MEDICAL GROUP
Doing business as
Sentara Surgery Specialists
Practice address
5659 Parkway Dr Ste 220
Gloucester, VA 23061-3792
Phone
(757) 736-7280
Fax
(757) 510-9186
NPI assigned
Oct 9, 2020
Last updated
Oct 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Doris Prince
Title
Director
Phone
(757) 252-2760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

5659 Parkway Dr Ste 220
Gloucester, VA 23061-3792

Mailing address

5659 Parkway Dr Ste 220
Gloucester, VA 23061-3792
Phone (757) 736-7280

Other names 1

  • Sentara Surgery Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Int Medi188 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5659 Parkway Dr
Ste 220
Gloucester, VA 23061
Phone (757) 736-7280

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1902404296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5659 PARKWAY DR STE 220",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613792",
            "telephone_number": "757-736-7280",
            "fax_number": "757-510-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5659 PARKWAY DR STE 220",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230613792",
            "telephone_number": "757-736-7280",
            "fax_number": "757-510-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-252-2760"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Surgery Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gloucester, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.