Bon Secours-Virginia Healthsource

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BON SECOURS-VIRGINIA HEALTHSOURCE

Doing business as

James River Surgical Associates - Hanover

Practice address

8220 Meadowbridge Rd
Suite 308
Mechanicsville, VA 23116

Phone

(804) 764-7686

Fax

(804) 764-7689

NPI assigned

Jun 5, 2007

Organization subpart

Yes

Parent organization

BON SECOURS-VIRGINIA HEALTHSOURCEAs reported in NPPES

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

Authorized official

Name

George O. Butler, MBA

Title

Director, Corporate Responsibility

Phone

(804) 281-0271

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• James River Surgical Associates - Hanover Doing business as

Part of

Beaverdam Family Phy

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532649600000",
    "number": "1912109497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8220 MEADOWBRIDGE RD",
            "address_2": "SUITE 308",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162336",
            "telephone_number": "804-764-7686",
            "fax_number": "804-764-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 MEADOWBRIDGE RD",
            "address_2": "SUITE 308",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23116",
            "telephone_number": "804-764-7686",
            "fax_number": "804-764-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BON SECOURS-VIRGINIA HEALTHSOURCE",
        "enumeration_date": "2007-06-05",
        "last_updated": "2018-07-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "DIRECTOR, CORPORATE RESPONSIBILITY",
        "authorized_official_telephone_number": "804-281-0271",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James River Surgical Associates - Hanover",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "James River Surgical Associates - Hanover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bon Secours Virginia Medical Group I, LLC (Bon Secours Behavioral Health Group at Memorial Regional)
• Bon Secours Virginia Medical Group I, LLC (Bon Secours Caryn Malkman, MD)
• Bon Secours Virginia Medical Group II, LLC (James River Surgical Associates-Women's Services)
• Bon Secours-St. Mary's Hospital of Richmond, Inc. (Bon Secours St. Mary's Hospital Sleep Lab)
• Bon Secours-St. Mary's Hospital of Richmond, Inc. (The Bon Secours Program for Diabetes Health)
• Bon Secours-Virginia Healthsource Inc (Bon Secours Sleep Disorders Center)
• Bon Secours-Virginia Healthsource Inc (James River Surgical Associates-Women's Services)
• Mark C Bond, DDS
• Linda Bonham, P.T.
• Anna Kristina Bonner, F.N.P-B.C.

• Surgery Physician in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.