NPIMap

Organization Active NPI

Bon Secours Depaul Medical Center Inc

  • Pain Medicine Physician
  • Norfolk, VA
National Provider Identifier
1902929144
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
BON SECOURS DEPAUL MEDICAL CENTER INC
Practice address
150 Kingsley LN
Norfolk, VA 23505-4602
Phone
(757) 869-7858
Fax
(757) 398-4420
NPI assigned
Apr 10, 2007
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
Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

150 Kingsley LN
Norfolk, VA 23505-4602

Mailing address

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

Other names 1

  • DePaul Palliative Program 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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1902929144",
    "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": "150 KINGSLEY LN",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054602",
            "telephone_number": "757-869-7858",
            "fax_number": "757-398-4420"
        }
    ],
    "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": "2007-04-10",
        "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": "208VP0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DePaul Palliative Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DePaul Palliative Program",
            "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.